SCI 발표논문

1. 192012

   제1저자 곽수헌 · 교신저자 박경수

   Kwak SH, Park BL, Kim H, German MS, Go MJ, Jung HS, Koo BK, Cho YM, Choi SH, Cho YS, Shin HD, Jang HC, Park KS

   Association of variations in TPH1 and HTR2B with gestational weight gain and measures of obesity.

   Obesity (Silver Spring). 2012;20(1):233-8.

   Abstract

   Serotonin is involved in appetite regulation and energy homeostasis. Recently, it has been reported that 5-hydroxytryptamine receptor 2B (Htr2b) and tryptophan hydroxylase 1 (Tph1) play major role in β-cell proliferation in mouse during pregnancy. We investigated the genetic association of HTR2B and TPH1 with risk of gestational diabetes mellitus (GDM) and measures of obesity, in 869 Korean GDM women and carefully selected 632 nondiabetic control subjects. Six single-nucleotide polymorphisms (SNPs) in HTR2B and ten SNPs in TPH1 were selected for genotyping according to their tagging status. Genetic variants in HTR2B and TPH1 were not associated with the risk of GDM. In GDM women, SNPs of TPH1 were significantly associated with weight gain during pregnancy. In nondiabetic controls, SNPs of TPH1 were associated with waist circumference and BMI. We also found that a variant of TPH1 (rs623580) was associated with BMI in a genome-wide association study comprised of 8,842 subjects. Although genetic variants in HTR2B and TPH1 were not associated with risk of GDM, we found significant association of these variants with measures of obesity. However, further replication studies in a different population are required to confirm our findings.

   PubMed IF 4.9 내분비대사내과
2. 182012

   제1저자 이은주 · 교신저자 김효수

   Lee EJ, Choi EK, Kang SK, Kim GH, Park JY, Kang HJ, Lee SW, Kim KH, Kwon JS, Lee KH, Ahn Y, Lee HJ, Cho HJ, Choi SJ, Oh WI, Park YB, Kim HS

   N-cadherin determines individual variations in the therapeutic efficacy of human umbilical cord blood-derived mesenchymal stem cells in a rat model of myocardial infarction.

   Mol Ther. 2012;20(1):155-67.

   Abstract

   In this study, we established and characterized human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) from four different donors. However, the hUCB-MSCs showed remarkable variations in their therapeutic efficacy for repairing rat infarcted myocardium (including the process of angiogenesis) 8 weeks after transplantation. In addition, we observed that the level of vascular endothelial growth factor (VEGF) is correlated with the therapeutic efficacy of the four hUCB-MSCs. Next, to investigate the practical application of hUCB-MSCs, we searched for surface signature molecules that could serve as indicators of therapeutic efficacy. The gene for N-cadherin was the only cell surface gene that was highly expressed in the most effective hUCB-MSCs, both at the transcriptional and translational levels. We observed downregulation and upregulation of VEGF in response to N-cadherin blocking and N-cadherin overexpression, respectively. Activation of extracellular signal-regulated kinase (ERK), but not protein kinase B, was increased when N-cadherin expression was increased, whereas disruption of N-cadherin-mediated cell-cell contact induced suppression of ERK activation and led to VEGF downregulation. Moreover, by investigating hUCB-MSCs overexpressing N-cadherin or N-cadherin knockdown hUCB-MSCs, we confirmed the in vivo function of N-cadherin. In addition, we observed that DiI-labeled hUCB-MSCs express N-cadherin in the peri-infarct area and interact with cardiomyocytes.

   PubMed IF 11.4 순환기내과
3. 172012

   제1저자 한승석 · 교신저자 진호준

   Han SS, Kang KJ, Kwon SJ, Wang SJ, Shin SH, Oh SW, Na KY, Chae DW, Kim S, Chin HJ

   Additional role of urine output criterion in defining acute kidney injury.

   Nephrol Dial Transplant. 2012;27(1):161-5.

   Abstract

   BACKGROUND Diagnosis of acute kidney injury (AKI) has been a major concern due to its association with increased morbidity and mortality. However, the clinical implication of the urine output criterion (UOCr) in diagnosing AKI has not been fully established.

   METHODS We assessed the incidence of AKI among 1625 critically ill patients and analysed the overall survival rates based on the serum creatinine criterion (CrCr) and UOCr, both of which have been defined by the AKI Network (AKIN).

   RESULTS Within 7 days of admission, the risk rate of AKI was 57.0% and the rate determined by UOCr alone was 25.7%. AKI determined by the UOCr alone increased hazard ratios (HRs) for mortality; 1.81 (Stage 1), 2.96 (Stage 2) and 4.17 (Stage 3) compared to non-AKI. However, the difference in mortality between Stages 2 and 3 using the CrCr alone was not significant (P = 0.881). In patients with Stages 2 and 3 by the CrCr, the UOCr further separated the survival rates (P = 0.001 among the four UOCr stages). The diuretic dose did not alter the discriminative function of the UOCr for survival rates. However, 42.1% of non-AKI cases, as determined by the UOCr, were identified as AKI cases by the CrCr.

   CONCLUSION Although some AKI cases were not identified by the UOCr alone, the UOCr has an additional role in AKI staging, regardless of diuretic use.

   PubMed IF 8.3 신장내과
4. 162012

   제1저자 오세원 · 교신저자 진호준

   Oh SW, Baek SH, Kim YC, Goo HS, Chin HJ, Na KY, Chae DW, Kim S

   Higher hemoglobin level is associated with subtle declines in renal function and presence of cardiorenal risk factors in early CKD stages.

   Nephrol Dial Transplant. 2012;27(1):267-75.

   Abstract

   BACKGROUND Patients with advanced renal dysfunction have comorbidities, including anemia, as a consequence of reduced production of erythropoietin. However, little is known about the renal response to early decreases in estimated glomerular filtration rate (eGFR) before the onset of anemia. We therefore investigated the hemoglobin concentration across subtle declines in renal function stratified by cardiorenal risk factors, in subjects with eGFR ≥50 mL/min/1.73 m(2).

   METHODS Based on the data from routine health checkups in tertiary university hospitals during the last 15 years, 145 865 adult subjects were identified.

   RESULTS Hemoglobin levels among eGFR Groups 2-6 (50 ≤ eGFR < 100 mL/min/1.73m(2)) were significantly higher compared to eGFR group ≥100 mL/min/1.73m(2) (P < 0.001), and the highest level of mean hemoglobin was seen at eGFR 50-59 mL/min/1.73m(2). The mean hemoglobin level of subjects with eGFR 50-59 mL/min/1.73m(2) and eGFR ≥ 100 mL/min/1.73m(2) were 13.36 [95% confidence interval (CI): 13.33-13.40] g/dL versus 12.92 (95% CI: 12.88-12.95) g/dL in women (P < 0.001); in men, 15.60 (95% CI: 15.57-15.63) g/dL versus 15.15 (95% CI: 15.11-15.18) g/dL (P < 0.001). Among each eGFR group, hemoglobin levels were higher in subjects with hypertension (P < 0.001 in both genders), diabetes mellitus (P < 0.001 in both genders) and components of MS (P < 0.003 in both genders) compared to subjects without these conditions.

   CONCLUSION Hemoglobin concentration may be slightly higher across subtle declines in renal function and the presence of cardiorenal risk factors in early CKD stages.

   PubMed IF 8.3 신장내과
5. 152012

   제1저자 박혜인조 · 교신저자 오윤규

   Park HC, Lee H, Lee JP, Kim DK, Oh KH, Joo KW, Lim CS, Kim YS, Ahn C, Oh YK

   Lower residual renal function is a risk factor for depression and impaired health-related quality of life in Korean peritoneal dialysis patients.

   J Korean Med Sci. 2012;27(1):64-71.

   Abstract

   We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck's Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. Moderate to severe depression was found in 24.8% of patients. Patients with lower normalized protein equivalent of nitrogen appearance (nPNA) (< 1.2 g/kg/day), lower weekly renal Kt/V(urea) (< 0.2), and lower serum albumin level (≤ 4.0 g/dL) were associated with depression (P < 0.05). Among them, lower weekly renal Kt/V(urea) was the only independent risk factor associated with depression (OR = 3.1, P = 0.007). Depressed patients showed significantly lower scores in every dimension of HRQOL (P < 0.001). Lower weekly renal Kt/V(urea) (β = 0.24, P = 0.005) and lower nPNA (β = 0.15, P = 0.03) were the independent risk factors associated with lower kidney dialysis component summary, whereas lower plasma hemoglobin level was the consistent risk factor for lower physical component summary (β = 0.22, P = 0.03) and mental component summary (β = 0.22, P = 0.01). Depression is a prevalent psychological problem in PD population. Residual renal function is the most important factor associated with depression and impaired HRQOL in PD patients.

   PubMed IF 3.2 신장내과
6. 142012

   제1저자 김인호 · 교신저자 Dunbar CE

   Kim I, Kim YJ, Métais JY, Dunbar CE, Larochelle A

   Transient silencing of PTEN in human CD34(+) cells enhances their proliferative potential and ability to engraft immunodeficient mice.

   Exp Hematol. 2012;40(1):84-91.

   Abstract

   The ability to expand hematopoietic stem and progenitor cells (HSPCs) in vitro will enhance the success of a wide range of transplant-related therapies. PTEN (phosphatase and tensin homologue deleted on chromosome 10) has been implicated as a regulator of murine HSPC self-renewal, but little is understood about the role of PTEN in human HSPC regulation. We tested the impact of transient small interfering RNA (siRNA)-induced inhibition of PTEN expression in human CD34(+) cells on their cell cycle profile, their susceptibility to retroviral transduction, and their ability to self-renew and repopulate nonobese diabetic/severe combined immunodeficiency disease with interleukin-2 receptor γ-chain deficiency mice. Reduced PTEN messenger RNA and protein levels were confirmed in PTEN siRNA-treated CD34(+) cells compared with control siRNA-treated CD34(+) cells. Transient silencing of PTEN in CD34(+) cells promoted their entry into cell cycle, and increased their expansion in vitro compared with control siRNA-treated CD34(+) cells. When these cells were transduced with retroviral vectors, transduction efficiencies in the bulk CD34(+) cells transfected with PTEN siRNA were significantly higher compared with CD34(+) cells transfected with a control siRNA. Transient PTEN suppression in CD34(+) cells also increased their proliferation and engraftment potential in nonobese diabetic/severe combined immunodeficiency disease with interleukin-2 receptor γ-chain deficiency mice, and maintained their multilineage differentiation capacity in vivo. No mice developed myeloproliferative disorders or leukemias. Similar to findings with murine HSPC, PTEN may also promote quiescence of human HSPC. With optimization of technologies for transfer of siRNA in primary CD34(+) cells, this approach may facilitate investigations into the mechanisms underlying HSPC self-renewal, and could find clinical applications in gene therapy protocols.

   PubMed IF 2.7 혈액종양내과
7. 132012

   제1저자 박주경 · 교신저자 류지곤

   Park JK, Ryu JK, Yoon WJ, Lee SH, Lee GY, Jeong KS, Kim YT, Yoon YB

   The role of quantitative NPTX2 hypermethylation as a novel serum diagnostic marker in pancreatic cancer.

   Pancreas. 2012;41(1):95-101.

   Abstract

   OBJECTIVES The majority of pancreatic cancers are found to be unresectable, and the only chance for cure lies on early detection and complete resection. Several genes have been discovered to be aberrantly methylated in primary pancreatic cancer tissue, and this cancer DNA can be detected in the plasma. The aims of this study were to develop a novel diagnostic marker based on epigenetic characteristics of pancreatic cancer.

   METHODS We enrolled 104 patients with pancreatic cancer, 60 with chronic pancreatitis, and 5 with benign biliary stone diseases. The blood samples were collected before surgery or any kinds of treatment modalities. DNA was extracted from the plasma of each patient, and NPTX2 (neuronal pentraxin II) CpG island hypermethylation was examined quantitatively by real-time polymerase chain reaction.

   RESULTS NPTX2 hypermethylation levels were significantly higher compared with chronic pancreatitis (P = 0.016). The sensitivity and specificity were 80% and 76%, respectively (cutoff = 0.015). NPTX2 gene hypermethylation level was significantly elevated in correlation with higher American Joint Committee on Cancer stages.

   CONCLUSIONS The aberrantly methylated NPTX2 gene may help to distinguish between chronic pancreatitis and pancreatic cancer with conventional diagnostic tools and could become a valuable diagnostic marker.

   PubMed IF 2.2 소화기내과
8. 122012

   제1저자 김유선 · 교신저자 김주성

   Kim YS, Kim YH, Kim JS, Cheon JH, Ye BD, Jung SA, Park YS, Choi CH, Jang BI, Han DS, Yang SK, Kim WH, IBD Study Group of the Korean Association for the Study of Intestinal Diseases

   The prevalence and efficacy of ganciclovir on steroid-refractory ulcerative colitis with cytomegalovirus infection: a prospective multicenter study.

   J Clin Gastroenterol. 2012;46(1):51-6.

   Abstract

   BACKGROUND It remains controversial whether or not cytomegalovirus infection in patients with active ulcerative colitis reflects a nonpathogenic colonization or a pathogenic disease warranting antiviral therapy.

   GOALS The aim of this study was to determine the prevalence of cytomegalovirus infection in patients with active ulcerative colitis and the therapeutic efficacy of ganciclovir against cytomegalovirus infection in patients with steroid-refractory ulcerative colitis.

   STUDY A prospective, multicenter study was conducted in 72 patients with moderate-to-severe ulcerative colitis who were treated with intravenous steroids. The presence of cytomegalovirus was evaluated serologically and histopathologic examination, including immunohistochemical staining. In patients with steroid-refractory ulcerative colitis, cytomegalovirus infections were treated with intravenous ganciclovir. In patients with steroid-responsive ulcerative colitis, steroid therapy was continued irrespective of cytomegalovirus infection.

   RESULTS The evidence of cytomegalovirus infection was found in 31 patients (43%) with moderate-to-severe active ulcerative colitis. In patients with steroid-refractory ulcerative colitis, the cytomegalovirus infection rate increased to 67% (14 of 21). No significant clinical and endoscopic differences existed between patients with and without a cytomegalovirus infection; however, the amount of steroids used during the flare-up period was significantly higher in patients with a cytomegalovirus infection (P = 0.013). Eleven of 14 patients (79%) with steroid-refractory ulcerative colitis and a cytomegalovirus infection improved with ganciclovir treatment. Cytomegalovirus infections in the steroid-responsive group (17 of 31) did not require ganciclovir therapy.

   CONCLUSIONS Cytomegalovirus infections are frequently observed in patients with moderate-to-severe ulcerative colitis, especially steroid-refractory ulcerative colitis. Ganciclovir was effective in patients with steroid-refractory ulcerative colitis who had a cytomegalovirus infection.

   PubMed IF 2.7 소화기내과
9. 112012

   제1저자 강정묵 · 교신저자 김나영

   Kang JM, Seo PJ, Kim N, Lee BH, Kwon J, Lee DH, Jung HC

   Analysis of direct medical care costs of peptic ulcer disease in a Korean tertiary medical center.

   Scand J Gastroenterol. 2012;47(1):36-42.

   Abstract

   OBJECTIVES There have been no reported data on the medical care cost of idiopathic peptic ulcer disease (PUD) compared with H. pylori (+) and/or NSAID (+) cases although H. pylori-negative idiopathic ulcers are increasing. The aim of this study was to investigate the direct medical care costs of PUD based on whether it was H. pylori infection/from NSAIDs or idiopathic.

   MATERIAL AND METHODS One hundred and seventy three patients with PUD comprising H. pylori and/or NSAID use-associated PUD (n = 145) and idiopathic PUD (n = 28) were prospectively enrolled in this study. The direct medical care costs were analyzed retrospectively for the patients with PUD during a one-year follow-up period.

   RESULTS The recurrence rate within one year was significantly higher in idiopathic PUD than H. pylori and/or NSAID-associated PUD (p = 0.002). Direct medical care costs of idiopathic PUD ($2483.8) were higher than in patients with H. pylori and/or NSAID-associated PUD ($1751.8) resulting from longer duration of medication and higher proportion of endoscopic hemostasis and hospitalization.

   CONCLUSIONS More clinical research is needed to improve outcome and reduce recurrence rate and medical care costs of idiopathic PUD.

   PubMed IF 1.8 소화기내과
10. 102012

    제1저자 김계형 · 교신저자 박완범

    Kim KH, Lee S, Lee S, Yun NR, Kim NJ, Yu KS, Jang IJ, Park WB, Oh MD

    Voriconazole-associated severe hyponatremia.

    Med Mycol. 2012;50(1):103-5.

    Abstract

    Voriconazole is the drug of choice for invasive aspergillosis. We describe three patients who presented with severe hyponatremia after the initiation of voriconazole treatment. One patient expired while the other two patients recovered after a dose adjustment or discontinuation of the antifungal. The voriconazole trough levels were checked in all and two were elevated. These findings mandate monitoring electrolyte levels during voriconazole therapy.

    PubMed IF 3.5 감염내과
11. 92012

    제1저자 박주희 · 교신저자 이동호

    Park JH, Lee DH, Kim JY, Park SY, Yoon H, Park YS, Kim N, Jeong SH, Kim JW, Lee SH, Hwang JH, Jung HC

    Gastroesophageal reflux disease with laryngopharyngeal manifestation in Korea.

    Hepatogastroenterology. 2012;59(120):2527-9.

    Abstract

    BACKGROUND/AIMS Globus pharyngeus and hoarseness are common extraesophageal manifestations inpatients with gastroesophageal reflux disease. The aim of this study was to evaluate the clinical characteristics, laryngoscopic findings, endoscopic findings, and response to proton pump inhibitors in patients presenting laryngeal symptoms suspected to be caused by GERD.

    METHODOLOGY We retrospectively reviewed the medical records of 160 patients that presented with globus and/or hoarseness and underwent acid suppression therapy under the impression of GERDfrom May 2003 to April 2009.

    RESULTS Sixty patients(37.5%) reported classical GERD symptoms such as heartburn and/or acid regurgitation. Sixty nine percent(69%) of patients (95/138) showed abnormal laryngoscopic findings such as laryngeal edema/hyperemia, vocal cord swelling/hyperemia, arytenoids swelling/hyperemia, vocal cord nodule, vocal cord polyp, post-glottic swelling/hyperemia, etc. Endoscopically, 41.9%(39/93) showed normal endoscopic findings and 49.5% (46/93) showed minimal changes. 8.6% (8/93)of patients showed erosive reflux disease. Therapeutic response was not significantly different among patients treated with standard dose PPIs (44/58, 75.9%),half dose PPIs (17/22, 77.3%), or revaprazan (18/21,85.7%).

    CONCLUSIONS Among patients with globus pharyngeus and/or hoarseness and suspected GERD, only 37.5% reported classical symptoms of GERD such as heartburn and/or acid regurgitation, 69% showed ab-normal laryngoscopic findings, 58.1% showed abnormal endoscopic findings, and 80% showed therapeutic response to acid suppression therapy.

    PubMed IF 0.658 소화기내과
12. 82012

    제1저자 서승철 · 교신저자 이동호

    Suh S, Nah JC, Uhm MS, Jung YM, Kim N, Lee DH, Jung HC, Song IS

    Changes in prevalence of Helicobacter pylori infection after subtotal gastrectomy.

    Hepatogastroenterology. 2012;59(114):646-8.

    Abstract

    BACKGROUND/AIMS There have been few reports comparing pre and postoperative prevalence of Helicobacter pylori infection and gastritis in patients with gastric cancer surgery.

    METHODOLOGY Seventy patients with primary gastric cancer were identified to be infected with Helicobacter pylori preoperatively and tested for Helicobacter pylori infection after subtotal gastrectomy. We analyzed changes in Helicobacter pylori infectivity and histological features of gastric mucosa.

    RESULTS The overall spontaneous regression rate of Helicobacter pylori infection was 38.6% (27/70). The mean time between surgery and follow-up tests was 1.02±0.5 years. The activity and chronic inflammation scores were significantly decreased in regression group. In non-regression group, there was no significant difference in activity scores, but the chronic inflammation score was significantly increased. There were no significant changes in atrophic gastritis and intestinal metaplasia scores in either group. The grade of Helicobacter pylori infection was significantly decreased in non-regression group.

    CONCLUSIONS The spontaneous regression rate of Helicobacter pylori infection after subtotal gastrectomy was 38.6% (27/70), it occurred in larger scale of patients and it occurred earlier (1.02±0.5 years) than in previous studies. We suggest that further prospective study on spontaneous regression rate of Helicobacter pylori infection after subtotal gastrectomy and its mechanism is needed in the future.

    PubMed IF 0.677 소화기내과
13. 72012

    제1저자 안동원 · 교신저자 이상협

    Ahn DW, Lee SH, Park YS, Shin CM, Hwang JH, Kim JW, Jeong SH, Kim N, Lee DH

    Hemostatic efficacy and clinical outcome of endoscopic treatment of Dieulafoy's lesions: comparison of endoscopic hemoclip placement and endoscopic band ligation.

    Gastrointest Endosc. 2012;75(1):32-8.

    Abstract

    BACKGROUND The most suitable mechanical endoscopic hemostasis for a bleeding Dieulafoy's lesion (DL) is not yet well established.

    OBJECTIVE To compare the hemostatic efficacy and clinical outcome of endoscopic hemoclip placement (EHP) and endoscopic band ligation (EBL).

    DESIGN Retrospective, single-center study.

    SETTING A tertiary-care referral university hospital.

    PATIENTS Sixty-six patients who received mechanical endoscopic hemostasis for bleeding DLs.

    INTERVENTIONS Endoscopic hemostasis.

    MAIN OUTCOME MEASUREMENT Primary hemostasis and rebleeding rates.

    RESULTS DLs accounted for 3.8% of cases of acute nonvariceal upper GI bleeding during the study period. Active bleeding from DLs was noted in 34 patients (51.5%). EHP and EBL were performed as a method of endoscopic hemostasis in 34 and 32 patients, respectively. There were no significant differences between the 2 groups with respect to baseline characteristics (except comorbidities) and endoscopic features of DLs. Primary hemostasis was achieved in all 66 patients (100%). There were 6 cases of recurrent bleeding: 5 (14.7%) and 1 (3.1%) in the EHP and EBL groups, respectively. Secondary hemostasis was achieved with endoscopic treatment and angiographic embolization in 5 patients and 1 patient, respectively, and no patients required surgery. The mean procedure time of endoscopic hemostasis was significantly longer in the EHP group (19.1 vs 11.5 minutes, P = .015). There was no bleeding-related mortality.

    LIMITATIONS Retrospective analysis.

    CONCLUSIONS Both EHP and EBL are suitable for the treatment of bleeding DLs. EBL can be used as an initial hemostatic method for bleeding DLs because of a favorable clinical outcome comparable to that with EHP and a shorter procedure time.

    PubMed IF 8 소화기내과
14. 62012

    제1저자 임수 · 교신저자 박경수

    Lim S, Choi SH, Koo BK, Kang SM, Yoon JW, Jang HC, Choi SM, Lee MG, Lee W, Shin H, Kim YB, Lee HK, Park KS

    Effects of aerobic exercise training on C1q tumor necrosis factor α-related protein isoform 5 (myonectin): association with insulin resistance and mitochondrial DNA density in women.

    J Clin Endocrinol Metab. 2012;97(1):E88-93.

    Abstract

    CONTEXT The C1q TNFα-related protein (C1QTNF) families exhibit a C-terminal complement factor C1q globular domain similar to that of TNF. However, their clinical implications are largely unknown. We recently found that the C1q TNFα-related protein isoform 5 (C1QTNF5 or myonectin) level was increased in insulin-resistant rodents and mitochondrial DNA (mtDNA)-depleted myocytes.

    OBJECTIVE We aimed to determine the effects of aerobic exercise training on C1QTNF5 level and its association with insulin resistance and mtDNA density in young and old healthy women.

    DESIGN AND SETTING Fourteen healthy young women aged 22.5 ± 2.7 yr and 14 healthy older women aged 60.3 ± 5.2 yr performed aerobic exercise at 60-80% of maximal oxygen consumption (VO(2)max) over three 1-h sessions per week for 10 wk. Insulin resistance was assessed by homeostasis model assessment of insulin resistance and adiponectin concentration. Serum C1QTNF5 level was estimated by immunoblotting. The mtDNA/28S rRNA ratio was used to determine mtDNA density.

    RESULTS VO(2)max increased significantly after the exercise training from 33.1 ± 6.2 to 35.3 ± 5.3 ml/kg · min in younger women and from 23.2 ± 3.1 to 27.2 ± 4.8 ml/kg · min in older women (P < 0.05). The C1QTNF5 level and homeostasis model assessment of insulin resistance decreased significantly after exercise training and were correlated positively (r = 0.462; P < 0.01). There were negative correlations between the changes in C1QTNF5 level and the changes in VO(2)max, mtDNA density, and adiponectin level (r = -0.495, -0.672, and -0.569, respectively; all P < 0.01).

    CONCLUSION These findings suggest a physiological function for C1QTNF5 (myonectin) in linking insulin resistance with quantitative changes in mtDNA. Further research exploring the role of C1QTNF5 in the development of insulin resistance is warranted.

    PubMed IF 5.4 내분비대사내과
15. 52012

    제1저자 임수 · 교신저자 장학철

    Lim S, Shin H, Kim MJ, Ahn HY, Kang SM, Yoon JW, Choi SH, Kim KW, Song JH, Choi SI, Chun EJ, Shin CS, Park KS, Jang HC

    Vitamin D inadequacy is associated with significant coronary artery stenosis in a community-based elderly cohort: the Korean Longitudinal Study on Health and Aging.

    J Clin Endocrinol Metab. 2012;97(1):169-78.

    Abstract

    CONTEXT Recent studies suggest an association between vitamin D activity and cardiometabolic risk.

    OBJECTIVE We investigated vitamin D status and its association with subclinical atherosclerosis in a population-based cohort study, the Korean Longitudinal Study on Health and Aging (KLoSHA).

    PARTICIPANTS Participants were 439 men and 561 women aged 65 yr or older who were recruited by random stratified sampling for KLoSHA.

    METHODS Anthropometric and biochemical parameters, the concentration of 25-hydroxyvitamin D (25-OHD), and intact PTH were measured.

    MAIN OUTCOME MEASURES We evaluated the coronary artery calcium score and stenosis using multidetector-row cardiac computed tomography, the intima-media thickness using carotid sonography, pulse wave velocity, and the ankle-brachial index.

    RESULTS Among the participants, 49.8, 44.2, and 6.0% had 25-OHD deficiency (<15 ng/ml), insufficiency (15-29.9 ng/ml), and adequacy (≥30 ng/ml), respectively. The frequency of coronary artery stenosis (>50%) differed between 25-OHD categories: 18.5, 12.9, and 1.9% in the 25-OHD-deficient, -insufficient, and -adequate groups, respectively (P < 0.05). After adjusting for cardiometabolic risks and intact PTH concentration, multivariate regression analysis showed that participants with a low 25-OHD concentration had a higher risk of significant coronary artery stenosis; the odds ratios were 2.08 for 25-OHD concentration of 15-29.9 ng/ml vs. at least 30 ng/ml and 3.12 for 25-OHD concentration below 15 ng/ml vs. at least 30 ng/ml (both P < 0.05).

    CONCLUSIONS The association between 25-OHD inadequacy and subclinical atherosclerosis underscores the clinical implications of vitamin D status. An intervention strategy to increase vitamin D level through vitamin D-fortified diet and adequate sun exposure may mitigate the consequences of vitamin D deficiency.

    PubMed IF 5.4 내분비대사내과
16. 42012

    제1저자 박경우 · 교신저자 김효수

    Oh IY, Park KW, Kang SH, Park JJ, Na SH, Kang HJ, Koo BK, Jeong YH, Hwang JY, Kwak CH, Park Y, Hwang SJ, Ko YG, Shin DJ, Jang Y, Kim HS

    Association of cytochrome P450 2C19*2 polymorphism with clopidogrel response variability and cardiovascular events in Koreans treated with drug-eluting stents.

    Heart. 2012;98(2):139-44.

    Abstract

    BACKGROUND Although East Asians carry the cytochrome P450 (CYP) 2C19*2 allele more frequently than do Caucasians, the impact of the CYP2C19*2 allele on clopidogrel pharmacodynamics and clinical outcomes is unknown.

    OBJECTIVE To evaluate the effect of CYP2C19 variants on clopidogrel pharmacodynamics and long-term prognosis in East Asian patients with drug-eluting stents (DES).

    METHODS DES-treated patients taking dual antiplatelet therapy were enrolled from a Korean multicentre genetic registry. The CYP2C19*2 allele was genotyped using the Taqman method (n=2146), and on-treatment platelet reactivity was measured with the VerifyNow P2Y12 assay (n=1415).

    RESULTS 1011 patients (47%) carried at least one CYP2C19*2 allele. The mean on-treatment platelet reactivity was significantly higher in carriers than in non-carriers (250±76 vs 231±83 P2Y12 reaction unit, p<0.001). For up to 12 months' follow-up, the composite of cardiovascular death, non-fatal myocardial infarction and stent thrombosis was significantly higher in carriers of the CYP2C19*2 allele than non-carriers (2.0% vs 0.8%, p=0.02). On landmark analysis, there was no difference in clinical outcome after 12 months between the groups.

    CONCLUSION The CYP2C19*2 genetic variant may be associated with worse outcome in Korean patients treated exclusively with DES and dual-antiplatelet therapy due to a significant increase in cardiac death, myocardial infarction or stent thrombosis.

    PubMed IF 4.4 순환기내과
17. 32012

    제1저자 최수연 · 교신저자 오병희

    Choi SY, Park HE, Kim MK, Shin CS, Cho SH, Oh BH

    Difference between calculated and direct-measured low-density lipoprotein cholesterol in subjects with diabetes mellitus or taking lipid-lowering medications.

    J Clin Lipidol. 2012;6(2):114-20.

    Abstract

    OBJECTIVE We evaluated factors that caused differences between calculated low-density lipoprotein cholesterol (C-LDL-C) and direct-measured LDL-C (D-LDL-C) and compared them in subjects with diabetes mellitus (DM) or taking lipid-lowering medications.

    METHODS 21,452 subjects (9,177 women, 12,275 men; 8.1% with DM and 8.5% on lipid-lowering medications) were included in the analysis. Participants were classified into 3 groups, i.e., group 1: the subjects without DM and not on lipid-modifying drugs (n = 18,287), group 2: without DM and on lipid-modifying drugs (n = 1,423), and group 3: with DM (n = 1,742). LDL-C concentrations were either directly measured by a homogenous method or calculated by Friedewald formula.

    RESULTS There was a significant correlation between C-LDL-C and D-LDL-C (r = 0.966, P < .001). The absolute values of the differences between two LDL-C values were 7.0 ± 6.2 mg/dl and 6.6 ± 7.3% (6.6 ± 5.9 mg/dl and 6.0 ± 6.5%, 8.8 ± 6.7 mg/dl and 9.1 ± 9.7%, and 10.1 ± 7.3 mg/dl and 10.7 ± 10.1% in group 1, 2, and 3 respectively, P < .001). The subjects with the absolute value of the differences of LDL-C ≥10% was 20.2% (17.3%, 31.3%, and 41.1% in group 1, 2, and 3 respectively, P < .001). In the multiple logistic regression analysis, high triglyceride (≥150 mg/dl), low high-density lipoprotein cholesterol (HDL-C) (<40 mg/dl), male gender, obesity (body mass index ≥25 kg/m(2)), DM and taking lipid-lowering drugs were significant associated with high LDL-differences (the absolute value of the differences ≥10% or ≥10 mg/dl).

    CONCLUSION D-LDL-C was generally higher by 5 mg/dl or 5% than C-LDL-C. The differences C-LDL-C and D-LDL-C were higher in subjects with DM and on lipid-lowering medications. Male gender, high triglyceride, low HDL-C, and obesity were also associated with the greater differences between C-LDL-C and D-LDL-C.

    PubMed IF 6.9 순환기내과
18. 22012

    제1저자 장제현 · 교신저자 김세중

    Chang JH, Sung JY, Nam HE, Jeong H, Jo MY, Hwang YH, Jung JY, Lee HH, Chung W, Sung YM, Kim S

    Role of coronary artery calcification score on the decrease in GFR among subjects with CT coronary angiography.

    Clin Exp Hypertens. 2012;34(1):24-30.

    Abstract

    OBJECTIVE Higher levels of coronary artery calcification score (CACS) are associated not only with an increased risk for cardiovascular death, but also with lower glomerular filtration rates (GFRs). However, its role in renal disease progression in patients has not been elucidated.

    MATERIALS AND METHODS We evaluated the change of estimated GFR in 279 nondialytic outpatients, who had undergone computed tomographic coronary angiography and follow-up over a period of 3 months.

    RESULTS The mean age of the participants was 57.7 ± 10.5 years, and the mean GFR was 88.2 ± 15.7 mL/min/1.73 m(2). Although there was no difference in baseline GFR between the CACS ≤ 200 AU group (n = 240) and the CACS > 200 AU group (n = 39), the latter group had a lower level of final GFR and higher annual reduction rate of GFR than the former group after an observation period of 13.1 ± 5.97 months. After adjusting for confounding variables, including age, gender, baseline GFR, albumin, and proteinuria, high levels of CACS showed an independent association with an annual reduction rate of GFR (r = -0.142, P = .048).

    CONCLUSIONS The results suggest that CACS was related to an annual decrease in GFR and may predict the faster decline in GFR in patients with symptoms requiring computed tomographic coronary angiography.

    PubMed IF 6.8 신장내과
19. 12012

    제1저자 임수, 김정희 · 교신저자 장학철

    Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, Kim KW, Cho NH, Shin H, Park KS, Jang HC

    Optimal cut points of waist circumference (WC) and visceral fat area (VFA) predicting for metabolic syndrome (MetS) in elderly population in the Korean Longitudinal Study on Health and Aging (KLoSHA).

    Arch Gerontol Geriatr. 2012;54(2):e29-34.

    Abstract

    Optimal cut points of central obesity identifying subjects at risk for MetS were proposed ethnic-specifically, but have not been established yet. Of particular interest are the values for elderly persons, which have not been identified previously. We investigated the appropriate cut points of WC and VFA for elderly in a community-based cohort in Korea. We recruited 294 men and 313 women aged 65 or over who participated in the KLoSHA. A receiver operating characteristic (ROC) curve analysis was used to estimate the optimal cut points of WC and VFA indicative of MetS. The optimal cut points for predicting MetS were 87 cm for WC, 140 cm(2) for VFA in men, and 85 cm for WC, 100 cm(2) for VFA in women with the Youden index. Similar cut points were obtained with the closest-to-(0, 1) criterion except for VFA in men, which was 122 cm(2). When adjusted for age, exercise, smoking, and alcohol consumption, men with ≥122 cm(2) and women with ≥100 cm(2) of VFA had a higher risk of MetS than subjects with lower values. The cut points of VFA and WC at risk for MetS were higher in men than women. In this community-based elderly cohort, the optimal cut points of WC at risk for MetS were lower than the Western criteria. Compared with the cut points in middle-aged Koreans, the cut points for elderly were lower in men and similar in women.

    PubMed IF 4.7 내분비대사내과

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