Endocrinology and Metabolism

Original Articles

Clinical Study
Association of Vitamin D Deficiency with Diabetic Nephropathy: So-hyeon Hong, Young Bin Kim, Hoon Sung Choi, Tae-Dong Jeong, Jin Taek Kim, Yeon Ah Sung; Endocrinol Metab. 2021;36(1):106-113. Published online February 24, 2021; DOI: https://doi.org/10.3803/EnM.2020.826

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Background
Low 25-hydroxyvitamin D (25OHD) levels are associated with the incidence of type 2 diabetes mellitus (T2DM). However, the association between 25OHD and metabolic health status or diabetic complications is inconclusive. We evaluated this relationship between vitamin D status and metabolic parameters and complications of T2DM.
Methods
This study included 1,392 patients with T2DM who visited Eulji and Ewha Diabetes Center between January 2011 and August 2016. Anthropometric parameters and laboratory tests including glycated hemoglobin (HbA1c), lipid profile, liver and kidney function, and urinary albumin-to-creatinine ratio (UACR) were evaluated. Diabetic macro- and microvascular complications were determined through a medical record review. Serum 25OHD concentrations were measured by chemiluminescent immunoassay.
Results
The mean 25OHD level was 16.8±9.6 ng/mL. Vitamin D deficiency (<20 ng/mL) and severe deficiency (<10 ng/mL) were observed in 990 (71.1%) and 351 (25.2%) participants, respectively. 25OHD level was positively correlated with age and highdensity lipoprotein cholesterol (HDL-C) level and negatively correlated with HbA1c, triglyceride level, and UACR. HDL-C and UACR were significantly associated with 25OHD after adjusting for other variables. Vitamin D deficiency was independently related to nephropathy after adjusting for confounding variables.
Conclusion
Vitamin D deficiency was common among Korean T2DM patients; it was independently associated with microalbuminuria and HDL level, and positively related to diabetic nephropathy.

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European Journal of Pharmacology.2024; 969: 176303. CrossRef
Vitamin D metabolism in diabetic nephropathy
Z. V. Abilov, R. Kh. Salimkhanov, A. A. Povaliaeva, A. Yu. Zhukov, E. A. Pigarova, L. K. Dzeranova, L. Ya. Rozhinskaya
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Luyan Zhang, Qian Guo, Yanjia Xu, Wenzhen Wei, Yu Wang
BMC Endocrine Disorders.2023;[Epub] CrossRef
Vitamin D deficiency and its associated factors among patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Mitku Mammo Taderegew, Gashaw Garedew Woldeamanuel, Alemayehu Wondie, Atsede Getawey, Abera Nesiru Abegaz, Fentahun Adane
BMJ Open.2023; 13(10): e075607. CrossRef
Progression of diabetic nephropathy and vitamin D serum levels: A pooled analysis of 7722 patients
Yomna E. Dean, Sameh Samir Elawady, Wangpan Shi, Ahmed A. Salem, Arinnan Chotwatanapong, Haya Ashraf, Tharun Reddi, Prashant Obed Reddy Dundi, Waleed Yasser Habash, Mohamed Yasser Habash, Safaa Ahmed, Hana M. Samir, Ahmed Elsayed, Aryan Arora, Abhinav Aro
Endocrinology, Diabetes & Metabolism.2023;[Epub] CrossRef
Incidence of Vitamin D Deficiency and Its Association With Microalbuminuria in Patients With Type 2 Diabetes Mellitus
Muhammad Hamza Riaz, Ammar Jamil, Hira Yousaf, Muhammad Hassan, Muhammad Ahmer Sohaib, Sharjeel Babar, Muhammad Hassan Ahmad, Ibtesam Allahi, Muhammad Zeshan Mehmood, Tayyab Mumtaz Khan
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The Role of Vitamin D in Diabetic Nephropathy: A Translational Approach
Charlotte Delrue, Reinhart Speeckaert, Joris R. Delanghe, Marijn M. Speeckaert
International Journal of Molecular Sciences.2022; 23(2): 807. CrossRef
Associations of serum amyloid A and 25‐hydroxyvitamin D with diabetic nephropathy: A cross‐sectional study
Qian Liu, Jin Sun, Tongdao Xu, Guangrong Bian, Fumeng Yang
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Formulation Strategies for Improving the Stability and Bioavailability of Vitamin D-Fortified Beverages: A Review
Elsa F. Vieira, Suene Souza
Foods.2022; 11(6): 847. CrossRef
Association between Vitamin D Status and Mortality among Adults with Diabetic Kidney Disease
Feng Xu, Hongyu Lu, Tianwen Lai, Ling Lin, Yongsong Chen, Pratibha V. Nerurkar
Journal of Diabetes Research.2022; 2022: 1. CrossRef
Assessment of the relationship between 25-hydroxyvitamin D and albuminuria in type 2 diabetes mellitus
Seyed Alireza Zomorodian, Maryam Shafiee, Zeinab Karimi, Fatemeh Masjedi, Amirhossein Roshanshad
BMC Endocrine Disorders.2022;[Epub] CrossRef
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Suyan Duan, Fang Lu, Buyun Wu, Chengning Zhang, Guangyan Nie, Lianqin Sun, Zhimin Huang, Honglei Guo, Bo Zhang, Changying Xing, Yanggang Yuan
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Francesco D’Egidio, Giorgia Lombardozzi, Housem E. Kacem Ben Haj M’Barek, Giada Mastroiacovo, Margherita Alfonsetti, Annamaria Cimini
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Nutritional Supplements for the Treatment of Neuropathic Pain
Khaled M. Abdelrahman, Kevin V. Hackshaw
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Vitamin D Deficiency as a Predictor of a High Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates With Type 1 Diabetes
Małgorzata Buksińska-Lisik, Przemysław J. Kwasiborski, Robert Ryczek, Wojciech Lisik, Artur Mamcarz
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Serum 25-hydroxyvitamin D and Metabolic Parameters in Healthy Korean Adults: Korean National Health and Nutrition Examination Survey VI
Jeonghoon Ha, Hansang Baek, Chaiho Jeong, Hyunsam Kim, Ki-Hyun Baek, Moo Il Kang, Dong-Jun Lim
International Journal of General Medicine.2021; Volume 14: 5233. CrossRef
Association Between 25(OH)Vitamin D, HbA1c and Albuminuria in Diabetes Mellitus: Data From a Population-Based Study (VIDAMAZON)
João Soares Felício, Hana Andrade de Rider Britto, Pedro Celeira Cortez, Fabrício de Souza Resende, Manuela Nascimento de Lemos, Lorena Vilhena de Moraes, Vitória Teixeira de Aquino, Fernanda de Souza Parente, Natércia Neves Marques de Queiroz, João Felíc
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A Clinical Study of Postpartum Autoimmute Thyroiditis.: Hee Jin Kim, Yeon Ah Sung, Nan Ho Kyung; J Korean Endocr Soc. 1996;11(3):302-310. Published online November 7, 2019

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Abstract PDF: Background
Postpartum thyroiditis is a painless, destructive lymphocytic inflammation of the thyroid gland that occurs during the postpartum period and is associated with a high prevalence of serum thyroid autoantibodies. Clinical symptoms and laboratory fi#ndings of postpartum thyroiditis vary widely during the course of illness and the final outcome of this disease remains unpredictive in some patients. The purpose of this study is to investigate the clinical course and the predictors of the outcome of the disease. Methods: Thirty-eight patients proven to have postpartum thyroiditis at the Ewha Womans University Hospital were studied. We analyzed their clinical features, laboratory findings and duration of recovery to characterize the course of the disease. Results: Their mean age was 29.0±3.3 years and the time of diagnosis was 4.9±1.9 months after delivery. The prevailed months of delivery were November through January in this study. Twenty six patients were hypothyroid and 12 were thyrotoxic at initial thyroid function. The positive rates of antithyroglobulin and anitmicrosomal antibodies were 92%, 67% in the hypothyroid group and 75%, 67% in th thyrotoxic group respectively. TSH receptor antibodies were negative in all patients. In the hypothyroid group the titers of antimicrosomal antibodies were significantly higer than the thyrotoxic group. The titers of antimicrosomal antibodies were positively correlated with serum TSH and negatively correlated with serum T4. In all patients, the titers in thyroid function tests returned to the normal range without long-term hypothyroidism. Conclusion: The titers of antimicrosomal antibodies were significantly higher in the hypothyroid group than the thyrotoxic group. Thus the titers of antimicrosomal antibodies can help guide the physician in the care of patients with postpartum thyroiditis who will probably be hypothyroid. In this study, we were surprised that all patients became euthyroid without permanent hypothyroidism.

Review Article

Polycystic Ovary Syndrome in Korean Women: Clinical Characteristics and Diagnostic Criteria.: Yeon Ah Sung; Endocrinol Metab. 2011;26(3):203-207. Published online September 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.3.203

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Abstract PDF

Polycystic ovary syndrome (PCOS) is a common disorder of premenopausal women, affecting 4 to 8% of this population. Diagnosis of PCOS lays on a combination of clinical, biological and ultrasound criteria that has been used variably worldwide. The phenotype of women with PCOS is variable depending on ethnic background and diagnostic criteria may rely on it. Fewer studies have extensively examined reproductive and metabolic characteristics and hyperandrogenism in Korean women. Despite the paucity of these studies, they are critical for the ascertainment of criteria for the diagnosis of PCOS. This review address the issues pertaining to diagnostic issues of PCOS in Korean women, specifically: reproductive and metabolic derangements and criteria for hyperandrogenism based on hirsutism and serum androgen concentrations. The prevalence (estimated) of PCOS in Korean women was 5.8%. To diagnose PCOS, the cut off value for hirsutism needs to be differently adjusted in Korean women. Regarding phenotypic characteristics of PCOS in Korean women, the various phenotypes of PCOS have the different overall morbidity (e.g. insulin resistance and hyperinsulinism, abnormal glucose metabolism and metabolic syndrome). Especially patients with oligomenorrhea/polycystic ovary and hyperandrogenism/polycystic ovary did not seem to have metabolic derangements. Thus these subgroups need to be determined if they can be classified as PCOS.

Citations

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Development of an integrated mobile application for lifestyle modification in women with polycystic ovarian syndrome
Hee Kyung Choi, Seon Heui Lee, Soo Yeon Yang
Journal of Clinical Nursing.2023; 32(1-2): 49. CrossRef
Trend changes and factor analysis of endometrial hyperplasia in patients with polycystic ovarian syndrome based on the Korean National Health Insurance Database
Bora Park, Hakmo Lee, Suyeon Park, Eun Sil Lee, Jeong Jae Lee, Young Lee, Je Hyun Seo
BMC Women's Health.2022;[Epub] CrossRef
Menstrual Cycle Patterns and the Prevalence of Premenstrual Syndrome and Polycystic Ovary Syndrome in Korean Young Adult Women
Young-Joo Park, Hyunjeong Shin, Songi Jeon, Inhae Cho, Yae-Ji Kim
Healthcare.2021; 9(1): 56. CrossRef

Editorial

A Study for the Factors Influencing Insulin Requirements in Type 2 Diabetic Patients.: Yeon Ah Sung; Endocrinol Metab. 2010;25(2):101-102. Published online June 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.2.101

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Abstract PDF: No abstract available.

Original Articles

Gly1057Asp Polymorphism of the Insulin Receptor Substrate-2 Genes May Not Have a Significant Impact on Insulin Resistance in Korean Women with Polycystic Ovary Syndrome.: Ji Young Oh, Jee Young Oh, Yeon Ah Sung, Hye Jin Lee, Hye Won Chung; J Korean Endocr Soc. 2009;24(2):100-108. Published online June 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.2.100

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Abstract PDF

BACKGROUND
Insulin resistance is a key factor in the pathogenesis of polycystic ovary syndrome (PCOS), and several candidate genes involved in insulin action such as insulin receptor or insulin recpetor substrate (IRS) have been investigated. In this study, we examined the genetic effects of the IRS-1 and IRS-2 genes on the metabolic and reproductive features in women with PCOS. METHODS: 125 patients with PCOS and 344 regular cycling controls were enrolled. Analysis of the polymorphisms of Gly972Arg in the IRS-1 gene and Gly1057Asp in the IRS-2 gene was performed and oral glucose tolerance tests and hyperinsulinemic euglycemic clamp tests were done. RESULTS: The genotype frequencies of the Gly972Arg polymorphism in the IRS-1 gene and the Gly1057Asp polymorphism in the IRS-2 gene were not significantly different between the women with PCOS and the controls. Gly972Arg polymorphism of the IRS-1 gene was extremely rare in both groups. PCOS women with the IRS-2 Asp1057Asp genotype showed significantly higher hirsutism scores, higher levels of free testosterone and higher post-load 60, 90, and 120 min plasma glucose levels compared to those women with the Gly1057Gly or Gly1057Asp genotype. In contrast, the control women with the Asp1057Asp genotype showed significantly lower post-load 60, 90, and 120 min plasma glucose levels compared with those women with the Gly1057Gly or Gly1057Asp genotype. CONCLUSION: Gly972Arg polymorphism of the IRS-1 gene was extremely rare in Korean women. Gly1057Asp polymorphism of the IRS-2 gene was associated with the phenotypic features of PCOS such as hirsutism, hyperandrogenemia and hyperglycemia, but it was not associated with the insulin sensitivity index. In conclusion, Gly1057Asp polymorphism of the IRS-2 gene may not have a significant impact on insulin resistance in Korean women with PCOS.

Citations

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Insulin Receptor Substrate 1 Gly972Arg (rs1801278) Polymorphism Is Associated with Obesity and Insulin Resistance in Kashmiri Women with Polycystic Ovary Syndrome
Shayaq Ul Abeer Rasool, Mudasar Nabi, Sairish Ashraf, Shajrul Amin
Genes.2022; 13(8): 1463. CrossRef

Calpain-10 Polymorphism in Korean Women with Polycystic Ovary Syndrome.: Hye jin Lee, Gun Woo Pyun, Eun Kyung Byun, Ji Young Oh, Jee Young Oh, Youngsun Hong, Yeon Ah Sung, Hye Won Chung; J Korean Endocr Soc. 2008;23(5):319-326. Published online October 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.5.319

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Abstract PDF

BACKGROUND
Polycystic ovary syndrome (PCOS) is characterized by chronic anovulation, hyperandrogenism and insulin resistance, and PCOS is known to be associated with an increased risk of type 2 diabetes mellitus (DM). PCOS has also been proposed to share a common genetic background with type 2 DM. The calpain 10 (CAPN10) gene is known to be associated with type 2 DM in several different population. We examined the association of CAPN10 gene polymorphisms and their influence on the metabolic abnormalities in Korean women who suffer with PCOS. METHODS: One hundred sixty four women with PCOS and 325 control women were studied. The CAPN10 gene polymorphisms were genotyped by amplifying the genomic DNA. Anthropometric measures, a 75g oral glucose tolerance test and measurement of insulin sensitivity by the euglycemic hyperinsulinemic clamp technique were performed. RESULTS: The frequencies of CAPN10 UCSNP-43, UCSNP-19, UCSNP-63 and the haplotype combinations were not different between the women with PCOS and the control subjects. In the women with PCOS and who had the UCSNP-43 GA genotype, the post-load 90 minute plasma glucose level was significantly greater and the HDL cholesterol and insulin mediated glucose uptake were significantly lower compared to the women with PCOS and who had the GG genotype. CONCLUSION: The CAPN10 UCSNP-43 genotype might be responsible for insulin resistance, yet further study is required to confirm the role of this genetic polymorphism in the development of PCOS and the presentation of its disease features.

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Comments on the latest meta-analysis of CAPN10 polymorphism associations with polycystic ovary syndrome
Sidra Raihan, Dawood Shariff, Sami Bizzari
Gene.2019; 717: 144006. CrossRef

Phenotypic Variation of Polycystic Ovary Syndrome.: Gun Woo Pyun, Young Ju Choi, Hyejin Lee, Jee Young Oh, Young Sun Hong, Yeon Ah Sung, Hye Won Chung; J Korean Endocr Soc. 2007;22(5):326-331. Published online October 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.5.326

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Abstract PDF

BACKGROUND
Polycystic ovary syndrome (PCOS) is a common disorder in premenopausal women, but there has been little agreement on its diagnostic criteria due to its uncertain pathogenesis and the heterogeneity of symptoms. This study was performed in order to assess the differences in clinical, metabolic, and hormonal characteristics of women in the PCOS subgroups defined by ESHRE criteria. METHODS: Subjects were divided into four PCOS subgroups based on ESHRE criteria. The grouping groupings included: 1) hyperandrogenism, oligomenorrhea, and polycystic ovary morphology (HA + OM + PCO); 2) hyperandrogenism and oligomenorrhea (HA + OM); 3) hyperandrogenism and polycystic ovary morphology (HA + PCO); and 4) oligomenorrhea and polycystic ovary morphology (OM + PCO). Reproductive hormones and metabolic profiles were measured. RESULTS: Of the total number of subjects, 60 (40%) fulfilled the criteria for HA + OM + PCO, 50 (33%) for HA + OM, 11 (7%) for HA + PCO, and 30 (20%) for OM + PCO. There were no significant differences in clinical or metabolic features among the groups, except for LH, total cholesterol, and HDL cholesterol. CONCLUSION: In this population defined by ESHRE criteria, 73% of the patients met the former NIH definition for PCOS. Different phenotypes of PCOS cases were clinically or biochemically similar. Whether these women have an increased risk of infertility or metabolic complications remains to be determine.

Citations

Citations to this article as recorded by

Epidemiology and Diagnostic Criteria of Polycystic Ovary Syndrome
Hyejin Lee, Yeon-Ah Sung
The Journal of Korean Diabetes.2015; 16(3): 189. CrossRef
Hyperandrogenism in Women: Polycystic Ovary Syndrome
Yeon-Ah Sung
Hanyang Medical Reviews.2012; 32(4): 197. CrossRef
Polycystic Ovary Syndrome in Korean Women: Clinical Characteristics and Diagnostic Criteria
Yeon-Ah Sung
Endocrinology and Metabolism.2011; 26(3): 203. CrossRef
Clinical Manifestation of Polycysticv Ovary Syndrome
Yu-Bae Ahn
Journal of Korean Endocrine Society.2007; 22(5): 323. CrossRef

Review Article

Diagnosis and Treatment of Polycystic Ovary Syndrome.: Hyejin Lee, Yeon ah Sung; J Korean Endocr Soc. 2007;22(4):252-256. Published online August 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.4.252

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Abstract PDF: No abstract available.

Original Articles

Adiponectin and Ghrelin Polymorphism in Korean Women with Polycystic Ovary Syndrome.: Hyejin Lee, Eun Kyung Byun, Hwi Ra Park, Jee Young Oh, Youngsun Hong, Yeon Ah Sung, Hyewon Chung; J Korean Endocr Soc. 2006;21(5):394-401. Published online October 1, 2006; DOI: https://doi.org/10.3803/jkes.2008.21.5.394

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Abstract PDF: BACKGROUND
Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism and chronic anovulation, and this is a common disorder in premenopausal women. However, the pathogenesis is still uncertain. There has been no studies about PCOS-related genetic abnormalities in Korea. In this study, we examined the frequency of the adiponectin and ghrelin genotypes in Korean women with PCOS. METHODS: Fifty four women with PCOS and 174 regular cycling healthy women were recruited for the study, and their reproductive hormones and metabolic profiles were measured. The polymorphisms of the ghrelin and adiponectin genes were analyzed. RESULTS: The frequency of ghrelin gene polymorphism was not different between the women with PCOS and the controls. The frequency of the TG adiponectin genotype was higher and the frequency of the TT genotype was lower in the women with PCOS compared to the controls (P < 0.05). For the PCOS women with GG adiponectin genotype, their triglycerides levels were significantly higher compared to the PCOS women with the TT and TG genotypes even after adjusting for the BMI. CONCLUSION: Adiponectin gene polymorphism is associated with presence of PCOS and it is responsible for the dyslipidemia seen in PCOS. Yet further study is required to confirm the role of this genetic polymorphism in the susceptibility to PCOS and the associated metabolic features.

Therapeutic Effects of Metformin and Rosiglitazone in Korean Women with Polycystic Ovary Syndrome.: Jee Young Oh, Eun Kyung Byun, Hwi Ra Park, Young Ju Choi, Hyo Jung Kim, Hye Jin Lee, Young Sun Hong, Yeon Ah Sung, Hye Won Chung; J Korean Endocr Soc. 2005;20(5):467-475. Published online October 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.5.467

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Abstract PDF

BACKGROUND
Insulin resistance is a central feature of polycystic ovary syndrome (PCOS), and hyperinsulinemia contributes to anovulation, oligo or amenorrhea, hyperandrogenism and infertility in women with PCOS. The use of insulin sensitizers, such as metformin or thiazolidinedione, in PCOS is becoming increasingly accepted. The purpose of our study was to evaluate the therapeutic effects of metformin and rosiglitazone on the metabolic and reproductive derangement, and find parameters predicting their therapeutic efficacy in Korean PCOS women. METHODS: Sixty-two women with PCOS were recruited. The baseline characteristics, including BMI, glucose tolerance test, lipid profiles, sex hormones and hyperinsulinemic euglycemic clamp test, were assessed. After the administration of the insulin sensitizer (metformin 1.5g/day or rosiglitazone 4mg/day) for 3 months, the insulin sensitivity was reassessed. A drug response was defined as menstrual restoration or pregnancy. RESULTS: Of the 62 women with PCOS, 36 gained restored regular menstruation, and a further 5 conceived (a drug response rate of 66.7%). There were no significant clinical differences between responders and nonresponders. Twelve weeks after taking the drugs, the insulin sensitivity was significantly improved (M-value 4.7+/-0.2 vs. 5.5+/-0.4mg/kg/min, P<0.05), and the free testosterone levels(72.5+/-39.9 vs. 45.8 +/-3.8pmol/L, P<0.05) were significantly decreased, without significant weight reduction. CONCLUSION: Metformin and rosiglitazone restored menstruation in 66.1% of women with PCOS. Hyperandrogenemia and insulin sensitivity were significantly improved with the use of the two drugs. However, metabolic or hormonal markers for predicting the drug response could not be found.

Citations

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Diagnosis and Treatment of Polycystic Ovary Syndrome
Hyejin Lee, Yeon-ah Sung
Journal of Korean Endocrine Society.2007; 22(4): 252. CrossRef

The Prevalence of Polycystic Ovary Syndrome in College Students from Seoul.: Eun Kyung Byun, Hyo Jeong Kim, Jee Young Oh, Young Sun Hong, Yeon Ah Sung; J Korean Endocr Soc. 2005;20(2):120-126. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.120

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Abstract PDF

BACKGROUND
Polycystic ovary syndrome(PCOS) is characterized by the presence of chronic anovulation and hyperandrogenism, The prevalence of PCOS in premenopausal women of about 5~ 10%. There may be significant ethnic and racial variations in the prevalence and clinical presentation of PCOS. The current study was undertaken to determine the prevalence of PCOS and to identify the clinical characteristics of PCOS in Korea. METHODS: From March 2003 to March 2004, medical students from Ewha Womans University were investigated for the prevalence of PCOS. The evaluation included a history and physical examination, a modified Ferriman-Gallwey hirsutism score and screening for hyperandrogenemia. PCOS was diagnosed by the presence of the following: 1) oligomenorrhea, 2) hyperandrogenemia and/or hirsutism(a modified Ferriman-Gallwey score> or =6), and 3) the exclusion of related disorders. Hyperandrogenemia was defined as a free testosterone level above the 95th percentile of that for normal cycling nonhirsute women. RESULTS: Out of 492 students, 386 replied to the questionnaire and 203 students(19~31 yr of age) participated in the physical examination and blood sampling. Eumenorrhea without hirsutism was present in 133 students(65.5%), oligomenorrhea was present in 39 students(19.2%), hyperandrogenism was present in 21 students(10.3%) and hirsutism was present in 3(1.5%) of the 203 women. The prevalence of PCOS was 4.9%(10 of 203 students), and only 2 of 10 women with PCOS were hirsute. The mean body mass index of students with PCOS was 22.7+/- 4.3kg/m2, and two women was obese. The plasma insulin levels during the 75g oral glucose tolerance test in women with PCOS was significantly higher when compared to the age and body mass index of the controls. CONCLUSION: The prevalence of PCOS was 4.9% in college students from Seoul. This rate is similar to those rates reported by other investigators in Greece(6.7%) and United States(4%). Obesity and hirsutism are not common in Korean women with PCOS. We are planning to survey a more diverse age groups to determine the prevalence of PCOS

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Hyperandrogenism in Women: Polycystic Ovary Syndrome
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Jin Ju Kim, Seon Ha Choung, Young Min Choi, Sang Ho Yoon, Seok Hyun Kim, Shin Yong Moon
Fertility and Sterility.2008; 90(6): 2318. CrossRef
A novel single nucleotide polymorphism of INSR gene for polycystic ovary syndrome
Eung-Ji Lee, Bermseok Oh, Jong-Young Lee, Kuchan Kimm, Sook-Hwan Lee, Kwang-Hyun Baek
Fertility and Sterility.2008; 89(5): 1213. CrossRef
Diagnosis and Treatment of Polycystic Ovary Syndrome
Hyejin Lee, Yeon-ah Sung
Journal of Korean Endocrine Society.2007; 22(4): 252. CrossRef
Single nucleotide polymorphism in exon 17 of the insulin receptor gene is not associated with polycystic ovary syndrome in a Korean population
Eung-Ji Lee, Kyong-Jai Yoo, So-Jeong Kim, Sook-Hwan Lee, Kwang Yul Cha, Kwang-Hyun Baek
Fertility and Sterility.2006; 86(2): 380. CrossRef

Association of Serum Adiponectin Levels with Insulin Resistance in Women with Polycystic Ovary Syndrome.: Young Sun Hong, Jee Young Oh, Eun Kyung Byun, Yeon Ah Sung; J Korean Endocr Soc. 2004;19(4):369-378. Published online August 1, 2004

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Abstract PDF: BACKGROUND
Polycystic ovary syndrome (PCOS) is known to be associated with obesity and insulin resistance. The exact mechanism of insulin resistance in PCOS is not completely understood, but there are several pieces of evidence suggesting humoral mediator involvement. Adiponectin, an adipocyte-secreted protein, could be a possible link between adiposity and insulin resistance. This study was performed to see whether the serum adiponectin levels are suppressed in woman with PCOS and if this is associated with the characteristic hormonal and metabolic features of PCOS. METHODS: 20 women with PCOS and 8 normal controls with regular cycles were recruited. The serum adiponectin levels were measured by RIA, and the fasting glucose to insulin ratio (GIR) used as an insulin sensitivity index. RESULTS: The patients with PCOS were classified as lean (BMI < 23 kg/m2, n=9) and obese groups (BMI 25 kg/m2, n=11) based on the WPRO criteria. The GIR was significantly lower in the obese compared to the control group. The adiponectin level was lower in women with PCOS than the controls, but without statistical significance. In 5 of the 20 patients, the GIR was higher than 0.30, which was the lowest limit in the controls, and the adiponectin level was significantly higher than in those patients with a lower GIR. The adiponectin level was significantly correlated with the BMI, subcutaneous and visceral fat areas, post challenge 2 hr glucose, fasting insulin, GIR and SHBG. After adjustment for BMI, adiponectin was significantly correlated with the GIR in all subjects, including the controls. CONCLUSION: The serum adiponectin level was associated with and related to adiposity in women with PCOS; however, adiponectin might be associated with insulin resistance independently from adiposity

Sex Hormone-Binding Globulin and Oxidative Stress in Korean Premenopausal Women.: Young Ju Choi, Jee Young Oh, Young Sun Hong, Yeon Ah Sung; J Korean Endocr Soc. 2004;19(1):48-57. Published online February 1, 2004

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Abstract PDF: BACKGROUND
Low levels of sex hormone-binding globulin(SHBG), an indirect index of androgenicity, are associated with insulin resistance and cardiovascular risk factors. The risk factors of the cardiovascular disease are known to be related to oxidative stress. In recent reports, sex hormones were associated with oxidative stress in women with polycystic ovarian syndrome(PCOS), which is characterized by increased androgenicity and insulin resistance. METHODS: To investigate the relationship between sex hormones and oxidative stress, we examined the association of malondialdehyde(MDA), total antioxidant status(TAS), oxidized low density lipoprotein cholesterol(ox-LDL), and SHBG in 46 Korean premenopausal women. RESULTS: 1. SHBG and MDA levels were not significantly different among the women with NGT and IGT. But, TAS was significantly lower(p=0.034) in the subjects with IGT than in the subjects with NGT. 2. The SHBG level was significantly lower(p=0.036) in obese women than in non-obese women. 3.The SHBG level was significantly inversely correlated with BMI(r=-0.394, p=0.007), post challenge glucose(r=-0.326, p=0.027), waist size(r=-0.323, p=0.029), waist-to-thigh ratio(WTR) (r=-0.308, p=0.037), fasting insulin level(r=-0.387, p=0.008), visceral fat area(VFA)(r=-0.339, p=0.021), and was significantly positively correlated with SI(r=0.397, p=0.008). 4. The SHBG level was significantly inversely correlated with levels of MDA(r=-0.357, p=0.015) and ox-LDL(r=-0.367, p=0.014). 5. In a multiple linear regression analysis, the SHBG level was a significant and independent factor for both MDA and ox-LDL. For TAS, the fasting insulin level and post challenge glucose were significant and independent factors. CONCLUSION: Increased androgenicity assessed by the decrease in serum SHBG levels is associated with the increase in MDA and ox-LDL. These results suggest that increased androgenicity in premenopausal women can contribute to the development of cardiovascular diseases via increased oxidative stress.

The Relationship between Dehydroepiandrosterone sulfate and Insulin Resistance Syndrome in Women.: Hyo Jeong Kim, Eun Soon Hong, Jee Young Oh, Young Sun Hong, Yeon Ah Sung; J Korean Endocr Soc. 2002;17(5):675-684. Published online October 1, 2002

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Abstract PDF: BACKGROUND
Dehydroepiandrosterone (DHEA) is an androgen precursor, and is known to be decreased by the aging process. DHEA has been known to have a protective effect on insulin resistance and cardiovascular disease in men, but remains controversial in women. The aim of this study was to elucidate the role of DHEA on insulin resistance, and the risk for cardiovascular disease, in women. METHODS: We analyzed the relationship between DHEA sulfate (DHEAS), known to have a longer half-life and less diurnal variation than DHEA, and insulin resistance syndrome (IRS) in 471 non-diabetic women from an urban community diabetes prevalence study. Serum DHEAS concentrations were measured using a commercially available radioimmunoassay kit. RESULTS: 1. The frequencies of obesity, impaired glucose tolerance, hypertension and dyslipidemia were 25.3, 8.5, 21.9 and 6.2%, respectively, and the frequency of IRS was 16.5%. 2. DHEAS was significantly inversely correlated with age (r=-0.47, p<0.001), systolic blood pressure (r=-0.18, p<0.001), diastolic blood pressure (r=-0.10, p<0.05), fasting serum glucose (r=-0.10, p<0.05), postchallenge 2 hour glucose (r=-0.12, p<0.01) and triglycerides (r=-0.16, p<0.01). 3. As serum DHEAS concentrations, by quartiles, were decreased, the age-adjusted frequency of hypertension was significantly increased (p<0.05). 4. A Multiple linear regression analysis revealed that DHEAS was significantly associated with age (p<0.0001) and BMI (p<0.05). 5. A Logistic regression analysis showed that DHEAS was not associated with IRS after adjustment for age. CONCLUSION: DHEAS is inversely associated with age. DHEAS has no harmful effect, and may even have a protective role, on insulin resistance syndrome. Prospective examinations of DHEAS and insulin resistance syndrome in women are needed to confirm the mechanism for the association between DHEAS and the development of cardiovascular disease.

Associations of Polymorphisms in Uncoupling Protein 2 and 3-Adrenergic Receptor with Obesity in Korean Adults.: Hyejin Lee, Hyeyoung Park, Youngsun Hong, Yeon Ah Sung; J Korean Endocr Soc. 2002;17(2):236-245. Published online April 1, 2002

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Abstract PDF: BACKGROUND
The genetic and environmental factors involved in the development of obesity and several candidate genes have been suggested to have an influence on energy and fuel metabolism. However, the specific genetic defects responsible for human obesity have not been identified yet. It is likely that a combination of polymorphisms in one or more candidate genes may affect energy metabolism and the development of obesity. We performed this study to determine the role of 45 bp insertion in the uncoupling protein (UCP)2 exon 8 and Trp64Arg polymorphism of beta3-adrenergic receptor ( 3-AR) gene in the regulation of body weight and the pattern of fat distribution. METHODS: In 114 subjects (male: 40, female: 74, mean body mass index: 24.1+/-2.7 kg/m2, 80 subjects with normal glucose tolerance, 34 subjects with impaired glucose tolerance), body fat distribution patterns were assessed by anthropometric measurement, bioelectric impedance analysis and computed tomogram. The genotypes of UCP genes were determined by polymerase chain reaction (PCR), and mutation in 3-AR gene by PCR followed by enzymatic digestion. RESULTS: In UCP2 genes, the frequency of deletion homozygote (DD) was 59.4%, heterozygote (DI) was 3.5% and insertion homozygote (II) was 3.1% Meanwhile, in 3-AR, the frequency of TrpTrp was 67.9%, TrpArg was 29.5% and ArgArg was 2.7%. In the lean group (subjects with a BMI less than 25 kg/m2), the frequencies of insertion allele and Arg64 allele were not significantly different than those among the overweight subjects (BMI > or = 25 kg/m2). There was not significant difference in clinical, biochemical or body fat distribution patterns between the groups according to UCP2 polymorphism. In the case of the polymorphism in 3-AR gene, the subjects with ArgArg homozygotes had lower HDL-cholesterol level (p<0.05). For the individuals over 40 years of age, BMI was greater among those with the deletion homozygotes and Arg64 allele, as compared to other groups according to the combination of UCP2 and 3-AR genotypes (p<0.05). CONCLUSION: These results suggest that genetic variations in UCP2 and 3-AR can synergistically affect metabolic rate and susceptibility to weight gain, thereby and contribute to the change in body weight in later life.

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