여성 제 2형 당뇨병 환자의 규칙적인 운동과 콩류 섭취 병행과 이상지혈증과의 관계

The dietary and lifestyle factors are important parameters contributing to better health in patients with type 2 diabetes. Several researchers suggest that when exercise is combined with soybeans and bean products consumption, the benefits appear to be more in a direction favorable in reducing CVD risk. Therefore, we examined whether regular exercise and soybeans and bean products consumption is related to CVD risk factors in Korean female patients with type 2 diabetes. A cross-sectional analysis was performed with 550 female patients, who were recruited from the Huh's Diabetes Clinic in Seoul from 2005 to 2011. The anthropometric and serological variables, and dietary intakes were assessed at the baseline. The patients were classified into four groups according to exercise and quantity of soybeans and bean products consumption: 1) non regular exercise and low soybeans consumption (NE-LS), 2) non regular exercise and high soybeans consumption (NE-HS), 3) regular exercise and low soybeans consumption (E-LS), 4) regular exercise and high soybeans consumption (E-HP). Differences were observed according to exercise, such that regular exercise group had more improved body weight (P=0.0295), BMI (P=0.0075), percent of body fat (P=0.0179), blood glucose (P=0.0226), HbA1c (P=0.0032), KITT (P=0.0332), LDL-cholesterol (P=0.0330) and Apo B (P=0.0442) than non regular exercise group. Differences were also observed according to quantity of soybeans and bean products consumption in such that increased soybean and bean product consumption group was favorably associated with LDL-cholesterol (P=0.0153), AI (P=0.0078) and LDL/HDL-cholesterol (P=0.0042) than low soybeans and bean products consumption group. Moreover, regular exercise with high soybeans and bean products consumption improved LDL-cholesterol (P=0.0126), which may improve CVD risk in female patients after adjustment for confounding factors. In conclusion, regular exercise with high soybeans and bean products consumption was associated with the reduction of LDL-cholesterol in female type 2 diabetes patients. Regular exercise or high soybeans and bean products consumption was beneficial for maintaining heart-healthy lipid profiles, however, combination of both may be more efficient. Therefore, moderate regular exercise with high soybeans and bean products consumption should be recommended for female patients with type 2 diabetes to prevent diabetic complications such as CVD.;식이요인 및 생활습관은 제2형 당뇨병 환자의 건강 증진에 영향을 미치는 중요한 요소이다. 선행연구에 따르면, 운동과 콩 및 그 제품 섭취 병행은 심혈관계질환 위험에 더욱 긍정적인 영향을 미친다고 나타냈다. 이에 본 연구는 한국인 여성 제2형 당뇨병 환자를 대상으로 규칙적인 운동과 콩 및 그 제품 섭취와 심혈관계질환 위험요인과의 관련성을 알아보고자 하였다. 본 연구의 대상자는 서울의 당뇨 전문 병원인 허내과에 내원한 여성 제2형 당뇨병 환자 550명으로 이들의 신체계측, 혈액성상, 식이섭취 상태를 조사했다. 규칙적인 운동 수행 여부와 콩 및 그 제품 섭취량을 기준으로 대상자들을 1) 불규칙적인 운동 수행과 콩 및 그 제품 섭취량이 낮은 군, 2) 불규칙적인 운동 수행과 콩 및 그 제품 섭취량이 높은 군, 3) 규칙적인 운동 수행과 콩 및 그 제품 섭취량이 낮은 군, 4) 규칙적인 운동 수행과 콩 및 그 제품 섭취량이 높은 군 으로 나누어서 비교했다. 그 결과, 규칙적인 운동 수행 여부에 따라서는 규칙적인 운동 수행 군이 불규칙적인 운동 수행 군에 비해 body weight (P=0.0295), BMI (P=0.0075), fat percent (P=0.0179), blood glucose (P=0.0226), HbA1c (P=0.0032), LDL-cholesterol (P=0.0330), Apo B (P=0.0442)는 낮은 반면 KITT (P=0.0332)는 높은 것으로 나타났고, 콩 및 그 제품의 섭취량에 따라서는 섭취량이 높은 군이 낮은 군에 비해LDL-cholesterol (P=0.0153), AI (P=0.0078), LDL/HDL-cholesterol (P=0.0042)이 낮은 것으로 나타났다. 또한, 규칙적인 운동 수행과 콩 및 그 제품 섭취량이 높은 군이 불규칙적인 운동 수행과 콩 및 그 제품 섭취량이 낮은 군에 비해 LDL-cholesterol (P=0.0126)이 낮은 것으로 나타났다. 규칙적인 운동 수행과 높은 콩류 및 그 제품 섭취 병행은 여성 제2형 당뇨병 환자에게서 LDL-cholesterol 수준과 긍정적인 관계가 있는 것으로 나타났다. 규칙적인 운동 또는 높은 콩류 및 그 제품 섭취 각각 혈중지질수준과 긍정적으로 관계되었지만, 이들을 병행할 때 더욱 효과적으로 나타났다. 따라서, 심혈관계질환과 같은 당뇨병성 합병증을 예방하기 위해 여성 제2형 당뇨병 환자에게 적당한 강도의 규칙적인 운동과 높은 콩 및 그 제품 섭취 병행이 권고되어야 할 것이다.Ⅰ. Introduction 1 Ⅱ. Materials and methods 4 A. Study subjects 4 B. Measurements 6 1. General characteristics 6 2. Anthropometric variables 6 3. Blood profiles 7 4. Dietary intakes 8 5. Dietary habits 9 C. Statistical analysis 10 Ⅲ. Results 12 A. General characteristics 12 B. Relationships of regular exercise and soybeans and bean products consumption and anthropometric variables, blood glucose and lipid profiles 14 1. Anthropometric variables 14 2. Blood glucose and lipid profiles 16 C. Comparison anthropometric variables, blood glucose and lipid profiles according to regular exercise and soybeans and bean products consumption 19 1. Anthropometric variables 19 2. Blood glucose and lipid profiles 23 D. Dietary intakes according to regular exercise and soybeans and bean products consumption 28 1. Food intakes 28 2. Nutrient intakes 30 3. Mini Dietary Assessment scores 36 Ⅳ. Discussion 39 Ⅴ. References 46 Appendix 54 국문초록 6

Effect of early-life antibiotic exposure and IL-13 polymorphism on atopic dermatitis phenotype

Background: Although atopic dermatitis (AD) is associated with certain gene variants, the rapidly increasing incidence of AD suggests that environmental factors contribute to disease development. In this study, we investigated the association of AD incidence and phenotype with antibiotic exposure within 6 months of age, considering the dose administered and genetic risk. Methods: This study included 1637 children from the COCOA cohort. Pediatric allergists assessed the presence of AD at each visit and obtained information about antibiotic exposure for more than 3 days. IL-13 (rs20541) polymorphism was genotyped by the TaqMan method. We stratified the AD phenotypes into four groups and used multinomial logistic regression models for analysis. Results: Antibiotic exposure within 6 months of age was found to increase the risk of AD within 3 years of life (aOR = 1.40; 95% CI, 1.09-1.81) in dose-dependent manner. Antibiotic exposure more than twice increased the risk of the early-persistent AD phenotype (aOR = 2.50; 95% CI, 1.35-4.63). There was a weak interaction between genetic polymorphisms and environmental factors on the development of AD (p for interaction = 0.06). Children with the IL-13 (rs20541) GA + AA genotype have a higher risk of the early-persistent AD phenotype when exposed to antibiotics more than twice than those with the IL-13 (rs20541) GG genotype and without exposure to antibiotics (aOR = 4.73; 95% CI, 2.01-11.14). Conclusion: Antibiotic exposure within 6 months was related to the incidence of early-persistent AD and a dose-dependent increase in the incidence of AD in childhood, whose effect was modified by the IL-13 (rs20541) genotype

Different Characteristics of Childhood Asthma Related to Polyhexamethylene Guanidine Exposure

Rationale: Exposure to humidifier disinfectants (HDs) can increase the risk of asthma, but the characteristics of HD-related asthma are currently unclear. Polyhexamethylene guanidine (PHMG)-containing HD was the most commonly used and the most frequently associated with HD-associated lung injury. Objectives: To investigate the characteristics of PHMG-induced asthma. Methods: This general population-based birth cohort study used data from the Panel Study of Korean Children from 2008 (n = 846). Spirometry, bronchial provocation tests, detailed history recording, and physical examinations were performed on 7-year-old patients (n = 362). Exploratory analysis of plasma proteomics was performed. Results: Compared with the healthy control group, forced expiratory volume in 1 second was the lowest in PHMG-exposed asthma group (z-score = 20.806; 95% confidence interval, 21.492 to 20.119). The positive rate of bronchial hyperresponsiveness was lower in children with PHMG-exposed asthma compared with children with asthma without HD exposure (13.3% vs. 47.4%). Long-term exposure to low-intensity PHMG before the age of 3 years was associated with asthma symptoms. Periostin was higher in subjects with asthma without HD exposure compared with the healthy control subjects. The inducible T-cell costimulator ligand and hepatocyte growth factor activator were lower in PHMG-exposed asthma compared with asthma without exposure. Hepatocyte growth factor activator had a positive correlation with forced vital capacity (z-score) in asthma with PHMG exposure (r = 0.78; P < 0.01). Conclusions: The asthma associated with low-intensity exposure to PHMG is characterized by lower lung function, lower positive rates of bronchial hyperresponsiveness, and varied distributions of plasma proteins. These findings suggest that asthma related to PHMG exposure may constitute a different mechanism of asthma pathophysiology

Interactions Between IL-17 Variants and Streptococcus in the Gut Contribute to the Development of Atopic Dermatitis in Infancy

Purpose: Interleukin (IL)-17 variants and perturbations in the gut microbiota may influence the development of atopic dermatitis (AD). However, unifying principles for variants of host and microbe interaction remains unclear. We sought to investigate whether IL-17 variants and gut microbiota affect the development of AD in infancy. Methods: Composition of the gut microbiota was analyzed in fecal samples from 99 normal healthy and 61 AD infants at 6 months of age. The associations between total immunoglobulin E (IgE), the scoring atopic dermatitis (SCORAD), short-chain fatty acids, transcriptome and functional profile of the gut measured in these subjects and Streptococcus were analyzed. IL-6 and IL-8 in the human intestinal epithelial cell line (HIEC-6) were measured after stimulation of IL-17 and Streptococcus mitis. Results: In this study, Streptococcus was enriched in infants with AD and was higher in those with the GA + AA of IL-17 (rs2275913) variant. Streptococcus was positively correlated with IgE and SCORAD in infants with AD and GA + AA of IL-17. Butyrate and valerate were negatively correlated with Streptococcus and were decreased in infants with AD and GA + AA. Bacterial genes for oxidative phosphorylation induced by reduced colonization of Clostridium were decreased compared with normal and GG. In transcriptome analysis, lactate dehydrogenase A-like 6B was higher in infants with AD compared with healthy infants. IL-6 and IL-8 were increased in IL-17 and/or S. mitis-stimulated HIEC-6 cells. Conclusions: These findings suggest that increased Streptococcus and A allele of IL-17 (rs2275913) may contribute to the pathogenesis of AD via modulation of the immune system in infancy

Integrative multi-omics approach for mechanism of humidifier disinfectant-associated lung injury

Integrative multi-omics approach for mechanism of humidifier disinfectant-associated lung injur