Time-dependent effects of intravenous infusion of fat on the glucose metabolism and the skeletal muscle glycogen synthase activity

학위논문(박사)--서울대학교 대학원 :의학과 내과학전공,1996.Docto

Dulaglutide as an Effective Replacement for Prandial Insulin in Kidney Transplant Recipients with Type 2 Diabetes Mellitus: A Retrospective Review

Dulaglutide, a weekly injectable glucagon-like peptide-1 receptor agonist, has demonstrated effectiveness when combined with basal insulin. We examined whether the efficacy of dulaglutide is comparable to that of prandial insulin in kidney transplant (KT) recipients with type 2 diabetes mellitus (T2DM) undergoing multiple daily insulin injection (MDI) therapy. Thirty-seven patients, who switched from MDI therapy to basal insulin and dulaglutide, were retrospectively analyzed. Changes in glycosylated hemo-globin (HbA1c) and fasting plasma glucose (FPG) levels, body weight, and basal insulin dose were evaluated over 6 months. Du-laglutide was comparable to three injections of prandial insulin in terms of glycemic control (HbA1c 7.1% vs. 7.0%; 95% confi-dence interval [CI], -0.53 to 0.28; P= 0.53). The basal insulin and dulaglutide combination resulted in a reduction in FPG levels by 9.7 mg/dL (95% CI, 2.09 to 41.54; P= 0.03), in body weight by 4.9 kg (95% CI, 2.87 to 6.98; P< 0.001), and in basal insulin dose by 9.52 IU (95% CI, 5.80 to 3.23; P< 0.001). Once-weekly dulaglutide may be an effective alternative for thrice-daily prandial insu-lin in KT recipients with T2DM currently receiving MDI therapy

Switching from insulin to dulaglutide therapy in patients with type 2 diabetes: A real-world data study

Aim Patients with type 2 diabetes (T2DM) who require injectable therapy have been conventionally treated with insulin. A glucagon-like peptide 1 receptor agonist was recently recommended as first-line injectable treatment, but few studies have investigated the effects of switching from insulin to dulaglutide. This study investigated the clinical efficacy and parameters affecting responses to dulaglutide as an alternative to insulin in patients with T2DM in a real-world clinical setting. Methods Ninety-eight patients with T2DM who were switched from insulin to dulaglutide therapy were retrospectively evaluated. Changes in HbA1c concentrations were assessed after 6 months of consistent treatment with dulaglutide. Multiple linear regression analysis was performed to evaluate parameters affecting the response to dulaglutide treatment. Results After treatment with dulaglutide for 6 months, patients experienced changes in HbA1c of -0.95% (95% confidence interval [CI]: -1.30% to -0.59%, P < 0.001) and in body weight of -1.75 kg (95% CI: -2.42 to -1.08 kg, P < 0.001). Multiple linear regression analysis showed that higher baseline HbA1c was significantly associated with a greater reduction in HbA1c. The most frequent adverse events were gastrointestinal symptoms. Conclusion Switching from insulin to dulaglutide can lead to significant improvement in HbA1c levels and body weight reduction in T2DM patients over 6 months. Higher baseline HbA1c is associated with a better clinical response to dulaglutide

The risk of Alzheimer's disease according to dynamic changes in metabolic health and obesity: a nationwide population-based cohort study

We evaluated the association of metabolic health and obesity phenotypes with the risk of Alzheimer's disease (AD). This study enrolled 136,847 elderly participants aged 60 or above from the Korean National Health Insurance System. At baseline examinations in 2009 and 2010, subjects were categorized into four groups: the metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO) groups. Based on the phenotypic transition after 2 years, the subjects were further categorized into 16 subgroups. They were followed from 2009 to 2015 to monitor for AD development. The MHO phenotype protected subjects from AD, relative to the MHNO phenotype (HR, 0.73; 95% CI, 0.65-0.81). Among subjects initially classified as MHO, 41.8% remained MHO, with a significantly lower risk of AD compared with the stable MHNO group (HR, 0.62; 95% CI, 0.50-0.77). Among MUO subjects at baseline, those who changed phenotype to MUNO were at higher risk of AD (HR, 1.47; 95% CI, 1.28-1.70), and the transition to the MHO phenotype protected subjects from AD (HR, 0.62; 95% CI, 0.50-0.78). The MHO phenotype conferred a decreased risk of AD. Maintenance or recovery of metabolic health might mitigate AD risk among obese individuals

HYBRID INDUCTION AND EGG DEVELOPMENT OF SERRANID FISHES THREE SPECIES

This study was conducted to analyze the differences in characteristics due to paternal influence occur to induce hybridization with female red spotted grouper and giant grouper, tiger grouper sperm. The fertilization rate were 89.0% in red spotted grouper ♀ X red spotted grouper ♂ (RR), 27.0% in red spotted grouper ♀ X tiger grouper ♂ (RT), 30.0% in red spotted grouper ♀ X giant grouper ♂ (RR). And fertilization rate of RR (control) is higher than other species. Hatching rate were 31.3% (RR), 18.8% (RT), 16.0% (RG), respectively. Result in observation the hybrid of three kinds(red spotted grouper, giant grouper, tiger grouper) by the egg occurrence speed and grow size, similar to the male progenitor egg occurrence speed was fastest in the RR of the control incubation phage. Length was the smallest as 2225.0 in the RR(control), however RG(hybrid) was the most fast growing in 2419.5. RT had a medium-growth rate, 2338.5.spotted grouper ♀ X red spotted grouper ♂ (RR), 27.0% in red spotted grouper ♀ X tiger grouper ♂ (RT), 30.0% in red spotted grouper ♀ X giant grouper ♂ (RR). And fertilization rate of RR (control) is higher than other species. Hatching rate were 31.3% (RR), 18.8% (RT), 16.0% (RG), respectively. Result in observation the hybrid of three kinds(red spotted grouper, giant grouper, tiger grouper) by the egg occurrence speed and grow size, similar to the male progenitor egg occurrence speed was fastest in the RR of the control incubation phage. Length was the smallest as 2225.0 in the RR(control), however RG(hybrid) was the most fast growing in 2419.5. RT had a medium-growth rate, 2338.5.1

Differential Effect of Metabolic Health and Obesity on Incident Heart Failure: A Nationwide Population-Based Cohort Study

Background Metabolically healthy obese (MHO) individuals and their association with cardiometabolic diseases have remained controversial. We aimed to explore the risk of incident heart failure (HF) based on the baseline metabolic health and obesity status as well as their transition over 2 years. Methods The Korean National Health Insurance Service-National Health Screening Cohort data of 514,886 participants were analyzed. Obesity was defined as BMI >= 25 kg/m(2) according to the Korean Centers for Disease Control and Prevention. The metabolic health and obesity status were evaluated at baseline and after two years. Study participants were followed to either the date of newly diagnosed HF or the last follow-up visit, whichever occurred first. Results The MHO group comprised 9.1% of the entire population and presented a better baseline metabolic profile than the metabolically unhealthy non-obese (MUNO) and metabolicavlly unhealthy obese (MUO) groups. During the median 71.3 months of follow-up, HF developed in 5,406 (1.5%) participants. The adjusted hazard ratios [HRs (95% CI)] of HF at baseline compared with the metabolically healthy non-obese (MHNO) group were 1.29 [1.20-1.39], 1.37 [1.22-1.53], and 1.63 [1.50-1.76] for MUNO, MHO, and MUO groups, respectively. With the stable MHNO group as reference, transition into metabolically unhealthy status (MUNO and MUO) increased the risk of HF, regardless of the baseline status. Subjects who were obese at both baseline and follow-up showed an increased risk of HF, regardless of their metabolic health status. Conclusions Metabolic health and obesity status and their transition can predict the risk of incident HF. Losing metabolic health in baseline non-obese and obese individuals and remaining obese in baseline obese individuals showed a significantly increased risk of incident HF. Maintaining good metabolic health and a lean body may prevent the development of HF