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대한당뇨병학회> Diabetes and Metabolism Journal (DMJ)> Adult Stem Cells: Beyond Regenerative Tool, More as a Bio-Marker in Obesity and Diabetes

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Adult Stem Cells: Beyond Regenerative Tool, More as a Bio-Marker in Obesity and Diabetes

Sabyasachi Sen
  • : 대한당뇨병학회
  • : Diabetes and Metabolism Journal (DMJ) 43권6호
  • : 연속간행물
  • : 2019년 12월
  • : 744-751(8pages)

DOI


목차

INTRODUCTION
WHY ADULT STEM CELLS
EFFECT OF EXERCISE ON ENDOTHELIAL PROGENITOR CELLS
CONCLUSIONS
CONFLICTS OF INTEREST
ORCID
ACKNOWLEDGMENTS
REFERENCES

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Obesity, diabetes, and cardiovascular diseases are increasing rapidly worldwide and it is therefore important to know the effect of exercise and medications for diabetes and obesity on adult stem cells. Adult stem cells play a major role in remodeling and tissue regeneration. In this review we will focus mainly on two adult stem/progenitor cells such as endothelial progenitor cells and mesenchymal stromal cells in relation to aerobic exercise and diabetes medications, both of which can alter the course of regeneration and tissue remodelling. These two adult precursor and stem cells are easily obtained from peripheral blood or adipose tissue depots, as the case may be and are precursors to endothelium and mesenchymal tissue (fat, bone, muscle, and cartilage). They both are key players in maintenance of cardiovascular and metabolic homeostasis and can act also as useful biomarkers.

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  • : 의약학분야  > 내과학
  • : KCI등재
  • : SCI,SCOPUS
  • : 격월
  • : 2233-6079
  • :
  • : 학술지
  • : 연속간행물
  • : 1972-2019
  • : 2668


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1Diabetes and Cancer: Cancer Should Be Screened in Routine Diabetes Assessment

저자 : Sunghwan Suh , Kwang-won Kim

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 733-743 (11 pages)

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Cancer incidence appears to be increased in both type 1 and type 2 diabetes mellitus (DM). DM represents a risk factor for cancer, particularly hepatocellular, hepatobiliary, pancreas, breast, ovarian, endometrial, and gastrointestinal cancers. In addition, there is evidence showing that DM is associated with increased cancer mortality. Common risk factors such as age, obesity, physical inactivity and smoking may contribute to increased cancer risk in patients with DM. Although the mechanistic process that may link diabetes to cancer is not completely understood yet, biological mechanisms linking DM and cancer are hyperglycemia, hyperinsulinemia, increased bioactivity of insulin-like growth factor 1, oxidative stress, dysregulations of sex hormones, and chronic inflammation. However, cancer screening rate is significantly lower in people with DM than that in people without diabetes. Evidence from previous studies suggests that some medications used to treat DM are associated with either increased or reduced risk of cancer. However, there is no strong evidence supporting the association between the use of anti-hyperglycemic medication and specific cancer. In conclusion, all patients with DM should be undergo recommended age- and sex appropriate cancer screenings to promote primary prevention and early detection. Furthermore, cancer should be screened in routine diabetes assessment.

2Adult Stem Cells: Beyond Regenerative Tool, More as a Bio-Marker in Obesity and Diabetes

저자 : Sabyasachi Sen

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 744-751 (8 pages)

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Obesity, diabetes, and cardiovascular diseases are increasing rapidly worldwide and it is therefore important to know the effect of exercise and medications for diabetes and obesity on adult stem cells. Adult stem cells play a major role in remodeling and tissue regeneration. In this review we will focus mainly on two adult stem/progenitor cells such as endothelial progenitor cells and mesenchymal stromal cells in relation to aerobic exercise and diabetes medications, both of which can alter the course of regeneration and tissue remodelling. These two adult precursor and stem cells are easily obtained from peripheral blood or adipose tissue depots, as the case may be and are precursors to endothelium and mesenchymal tissue (fat, bone, muscle, and cartilage). They both are key players in maintenance of cardiovascular and metabolic homeostasis and can act also as useful biomarkers.

3Two Faces of White Adipose Tissue with Heterogeneous Adipogenic Progenitors

저자 : Injae Hwang , Jae Bum Kim

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 752-762 (11 pages)

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Chronic energy surplus increases body fat, leading to obesity. Since obesity is closely associated with most metabolic complications, pathophysiological roles of adipose tissue in obesity have been intensively studied. White adipose tissue is largely divided into subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). These two white adipose tissues are similar in their appearance and lipid storage functions. Nonetheless, emerging evidence has suggested that SAT and VAT have different characteristics and functional roles in metabolic regulation. It is likely that there are intrinsic differences between VAT and SAT. In diet-induced obese animal models, it has been reported that adipogenic progenitors in VAT rapidly proliferate and differentiate into adipocytes. In obesity, VAT exhibits elevated inflammatory responses, which are less prevalent in SAT. On the other hand, SAT has metabolically beneficial effects. In this review, we introduce recent studies that focus on cellular and molecular components modulating adipogenesis and immune responses in SAT and VAT. Given that these two fat depots show different functions and characteristics depending on the nutritional status, it is feasible to postulate that SAT and VAT have different developmental origins with distinct adipogenic progenitors, which would be a key determining factor for the response and accommodation to metabolic input for energy homeostasis.

4New Diagnostic Criteria for Gestational Diabetes Mellitus and Pregnancy Outcomes in Korea

저자 : Kyu Yeon Hur

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 763-765 (3 pages)

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5Pregnancy Outcomes of Women Additionally Diagnosed as Gestational Diabetes by the International Association of the Diabetes and Pregnancy Study Groups Criteria

저자 : Min Hyoung Kim , Soo Heon Kwak , Sung-hoon Kim , Joon Seok Hong , Hye Rim Chung , Sung Hee Choi , Moon Young Kim , Hak C Jang

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 766-775 (10 pages)

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Background: We investigated the pregnancy outcomes in women who were diagnosed with gestational diabetes mellitus (GDM) by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by the Carpenter-Coustan (CC) criteria.
Methods: A total of 8,735 Korean pregnant women were identified at two hospitals between 2014 and 2016. Among them, 2,038 women participated in the prospective cohort to investigate pregnancy outcomes. Diagnosis of GDM was made via two-step approach with 50-g glucose challenge test for screening followed by diagnostic 2-hour 75-g oral glucose tolerance test. Women were divided into three groups: non-GDM, GDM diagnosed exclusively by the IADPSG criteria, and GDM diagnosed by the CC criteria.
Results: The incidence of GDM was 2.1% according to the CC criteria, and 4.1% by the IADPSG criteria. Women diagnosed with GDM by the IADPSG criteria had a higher body mass index (22.0±3.1 kg/m2 vs. 21.0±2.8 kg/m2, P<0.001) and an increased risk of preeclampsia (odds ratio [OR], 6.90; 95% confidence interval [CI], 1.84 to 25.87; P=0.004) compared to non-GDM women. Compared to neonates of the non-GDM group, those of the IADPSG GDM group had an increased risk of being large for gestational age (OR, 2.39; 95% CI, 1.50 to 3.81; P<0.001), macrosomia (OR, 2.53; 95% CI, 1.26 to 5.10; P=0.009), and neonatal hypoglycemia (OR, 3.84; 95% CI, 1.01 to 14.74; P=0.049); they were also at an increased risk of requiring phototherapy (OR, 1.57; 95% CI, 1.07 to 2.31; P=0.022) compared to the non-GDM group.
Conclusion: The IADPSG criteria increased the incidence of GDM by nearly three-fold, and women diagnosed with GDM by the IADPSG criteria had an increased risk of adverse pregnancy outcomes in Korea.

6Impact of Continuous Care on Health Outcomes and Cost for Type 2 Diabetes Mellitus: Analysis Using National Health Insurance Cohort Database

저자 : Ji Hyun Nam , Changwoo Lee , Nayoung Kim , Keun Young Park , Jeonghoon Ha , Jaemoon Yun , Dong Wook Shin , Euichul Shin

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 776-784 (9 pages)

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Background: The objective of the study was to determine the impact of continuous care on health outcomes and cost of type 2 diabetes mellitus (T2DM) in Korea.
Methods: A nationwide retrospective, observational case-control study was conducted. Continuity of treatment was measured using Continuity of Care (COC) score. Information of all patients newly diagnosed with T2DM in 2004 was retrieved from the National Health Insurance database for the period of 2002 to 2013. The study examined 2,373 patients after applying exclusion criteria, such as for patients who died from conditions not related to T2DM. Statistical analyses were performed using frequency distribution, simple analysis (t-test and chi-squared test), and multi-method analysis (simple linear regression, logistic regression, and survival analysis).
Results: The overall COC score was 0.83±0.24. The average incidence of diabetic complications was 0.39 per patient with a higher COC score, whereas it was 0.49 per patient with a lower COC score. In both survival and logistic analyses, patients who had high COC score were significantly less likely to have diabetic complications (hazard ratio, 0.69; 95% confidence interval, 0.54 to 0.88). The average medical cost was approximately 3,496 United States dollar (USD) per patient for patients with a higher COC score, whereas it was 3,973 USD per patient for patients with a lower COC score during the 2006 to 2013 period, with a difference of around 477 USD, which is statistically significant after adjusting for other factors (β=-0.152).
Conclusion: Continuity of care for diabetes significantly reduced health complications and medical costs from patients with T2DM.

7Early Assessment of the Risk for Gestational Diabetes Mellitus: Can Fasting Parameters of Glucose Metabolism Contribute to Risk Prediction?

저자 : Veronica Falcone , Grammata Kotzaeridi , Melanie Hanne Breil , Ingo Rosicky , Tina Stopp , Gulen Yerlikaya-schatten , Michael Feichtinger , Wolfgang Eppel , Peter Husslein , Andrea Tura , Christian S. Göbl

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 785-793 (9 pages)

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Background: An early identification of the risk groups might be beneficial in reducing morbidities in patients with gestational diabetes mellitus (GDM). Therefore, this study aimed to assess the biochemical predictors of glycemic conditions, in addition to fasting indices of glucose disposal, to predict the development of GDM in later stage and the need of glucose-lowering medication.
Methods: A total of 574 pregnant females (103 with GDM and 471 with normal glucose tolerance [NGT]) were included. A metabolic characterization was performed before 15+6 weeks of gestation by assessing fasting plasma glucose (FPG), fasting insulin (FI), fasting C-peptide (FCP), and glycosylated hemoglobin (HbA1c). Thereafter, the patients were followed-up until the delivery.
Results: Females with NGT had lower levels of FPG, FI, FCP, or HbA1c at the early stage of pregnancy, and therefore, showed an improved insulin action as compared to that in females who developed GDM. Higher fasting levels of FPG and FCP were associated with a higher risk of developing GDM. Moreover, the predictive accuracy of this metabolic profiling was also good to distinguish the patients who required glucose-lowering medications. Indices of glucose disposal based on C-peptide improved the predictive accuracy compared to that based on insulin. A modified quantitative insulin sensitivity check index (QUICKIc) showed the best differentiation in terms of predicting GDM (area under the receiver operating characteristics curve [ROC-AUC], 72.1%) or need for pharmacotherapy (ROC-AUC, 83.7%).
Conclusion: Fasting measurements of glucose and C-peptide as well as the surrogate indices of glycemic condition could be used for stratifying pregnant females with higher risk of GDM at the beginning of pregnancy.

8Relation between Baseline Height and New Diabetes Development: A Nationwide Population-Based Study

저자 : Eun-jung Rhee , Jung-hwan Cho , Hyemi Kwon , Se-eun Park , Jin-hyung Jung , Kyung-do Han , Yong-gyu Park , Yang-hyun Kim , Won-young Lee

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 794-803 (10 pages)

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Background: Short stature and leg length are associated with risk of diabetes and obesity. However, it remains unclear whether this association is observed in Asians. We evaluated the association between short stature and increased risk for diabetes using the Korean National Health Screening (KNHS) dataset.
Methods: We assessed diabetes development in 2015 in 21,122,422 non-diabetic Koreans (mean age 43 years) enrolled in KNHS from 2009 to 2012 using International Classification of Diseases 10th (ICD-10) code and anti-diabetic medication prescription. Risk was measured in age- and sex-dependent quintile groups of baseline height (20 to 39, 40 to 59, ≥60 years).
Results: During median 5.6-year follow-up, 532,918 cases (2.5%) of diabetes occurred. The hazard ratio (HR) for diabetes development gradually increased from the 5th (reference) to 1st quintile group of baseline height after adjustment for confounding factors (1.000, 1.076 [1.067 to 1.085], 1.097 [1.088 to 1.107], 1.141 [1.132 to 1.151], 1.234 [1.224 to 1.244]), with similar results in analysis by sex. The HR per 5 cm height increase was lower than 1.00 only in those with fasting blood glucose (FBG) below 100 mg/dL (0.979 [0.975 to 0.983]), and in lean individuals (body mass index [BMI] 18.5 to 23 kg/m2: 0.993 [0.988 to 0.998]; BMI <18.5 kg/m2: 0.918 [0.9 to 0.935]).
Conclusion: Height was inversely associated with diabetes risk in this nationwide study of Korean adults. This association did not differ by sex, and was significant in lean individuals and those with normal FBG levels.

9Diabetes and the Risk of Infection: A National Cohort Study

저자 : Eun Jin Kim , Kyoung Hwa Ha , Dae Jung Kim , Young Hwa Choi

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 804-814 (11 pages)

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Background: Several studies have shown that people with diabetes are vulnerable to infection. This study compared the risk of infection-related hospitalizations, intensive care unit (ICU) admission, and deaths between the person with diabetes and the general population in South Korea.
Methods: We conducted a cohort study of 66,426 diabetes and 132,852 age-sex-region-matched non-diabetes controls from the general population using a sample of data from the National Health Insurance Service-National Sample Cohort. The cohort was followed up for 9 years. Infections were classified into 17 separate categories. We used Poisson regression, with adjustment for household income and other comorbidities, to estimate incidence rate ratios (IRRs) in order to compare of infection-related hospitalizations, ICU admissions, and deaths.
Results: Compared to non-diabetes controls, diabetes group had a greater risk of almost all the types of infections considered, with the adjusted IRRs (aIRRs) for infection-related hospitalizations being the highest for hepatic abscess (aIRR, 10.17; 95% confidence interval [CI], 7.04 to 14.67), central nervous system (CNS) infections (aIRR, 8.72; 95% CI, 6.64 to 11.45), and skin and soft tissue infections other than cellulitis (SSTIs) (aIRR, 3.52; 95% CI, 3.20 to 3.88). Diabetes group also had a greater risk of ICU admission and death due to SSTIs (aIRR, 11.75; 95% CI, 7.32 to 18.86), CNS infections (aIRR, 5.25; 95% CI, 3.53 to 7.79), and bone and joint infections (aIRR, 4.78; 95% CI, 3.09 to 7.39).
Conclusion: In South Korea, people with diabetes has a considerably higher incidence of infection-related hospitalizations and deaths than the general population.

10Impact of Cytomegalovirus Disease on New-Onset Type 2 Diabetes Mellitus: Population-Based Matched Case-Control Cohort Study

저자 : Seul Gi Yoo , Kyung Do Han , Kyoung Hwa Lee , Yeonju La , Da Eun Kwon , Sang Hoon Han

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 6호 발행 연도 : 2019 페이지 : pp. 815-829 (15 pages)

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Background: A latent cytomegalovirus (CMV) cause chronic inflammation through undesirable inflation of cell-mediated immune response. CMV immunoglobulin G has been associated with cardiovascular disease and type 1 diabetes mellitus. We evaluated impact of CMV diseases on new-onset type 2 diabetes mellitus (T2DM).
Methods: From the Korean Health Insurance Review and Assessment Service claim database of entire population with 50 million, we retrieved 576 adult case group with CMV diseases diagnosed with International Statistical Classification of Diseases and Related-Health Problems 10th Revision (ICD-10) B25 code between 2010 and 2014 after exclusion of patients with T2DM to 2006. The 2,880 control patients without T2DM from 2006 to cohort entry point were selected between 2010 and 2014 by age, sex matching with case group. The subjects without new-onset T2DM were followed until 2015. T2DM, hypertension (HTN), dyslipidemia (DYS), and end-stage renal disease (ESRD) were coded as ICD-10.
Results: The frequency of new-onset T2DM in case group was significantly higher than that in control (5.6% vs. 2.2%, P<0.001). The group with T2DM (n=95) had higher incidence of CMV diseases than the group without T2DM (n=3,361) (33.7% vs. 16.2%, P<0.001). In multivariate regression model adjusted by age, sex, lower income, HTN, and DYS, the incidence rate (IR) of T2DM in case group was significantly higher than that in the control group (IR per 1,000, 19.0 vs. 7.3; odds ratio, 2.1; 95% confidence interval, 1.3 to 3.2). The co-existence of HTN, DYS, and ESRD with CMV diseases did not influence the IR of T2DM.
Conclusion: CMV diseases increase the patients' risk of developing T2DM.

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