http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
김홍규,서찬종,윤효중,황용하,이기영,박혜영,김갑환,강문호 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4
연구배경: 비알콜성 지방간은 일반적으로 비만, 제2형 당뇨병 및 고지혈증과 연관성이 있는 것으로 알려져 있으나, 인슐린 저항성과의 독립적인 연관성여부나, 대사 증후군과의 연관성에 관해서는 아직 연구가 많지 않다. 한편, 최근 건강검진센터를 중심으로, 초음파를 이용한 지방간의 진단이 흔하게 되었는데, 이런 대상에서의 지방간의 임상적인 의미에 대해서는 잘 알려져 있지 않았다. 따라서, 본 연구에서는 초음파로 진단된 비알콜성 지방간과 비만, 당대사이상, 이상지질혈증 및 인슐린 저항성과의 연관성을 알아보고, 대사성 증후군과 비알콜성 지방간의 동반정도를 알아보고자 하였다. 방법: 2000년도 4월부터 6월까지 종합건강진단을 위해 가천의대 길병원 건강증진센터에 내원한 262명 중 음주력과 바이러스성 간염, 심한 간기능 또는 신기능이상 및 현성 갑상선기능이상을 보인 147명을 제외한 115명을 대상으로 하였다. 지방간의 진단은 경험 있는 1명의 방사선과의사에 의해 복부 초음파로 진단하였다. 대사성 증후군의 정의는 당대사이상이 있으면서 비만, 이상지질혈증, 그리고 고혈압 중 두 가지 이상의 이상이 있는 경우로 하였다. 결과: 대상자 115명중 비알콜성 지방간이 있는 경우는 30명, 대조군은 85명이었다. 1) 수축기 및 이완기 혈압, 체중, 체질량지수, 체지방량 및 체지방률, 총콜레스테롤과 중성지방, 공복 혈중 인슐린 및 HOMA 인슐린저항성지표는 비알콜성 지방간군에서 의미 있기 높았다. 2) 나이, 성별, 체질량지수, 허리-둔부 둘레비, 체지방량, 체지방률, 공복혈당, 총콜레스테롤, 중성지방, HLD-콜레스테롤, 인슐린, HOMA 인슐린 저항성지표, 그리고 고혈압유무를 포함하여 로지스틱 회귀분석을 실시하였을 때, 체질량지수, 총 콜레스테롤 및 HOMA 인슐린저항성지표가 비알콜성 지방간과 독립적인 연관성이 있었다. 3) 비알콜성 지방간과 대사성 증후군의 연관성을 조사하였는데, 비알콜성 지방간을 가진 사람의 27%에서 대사성 증후군을 동반하였고, 대사성 증후군의 가진 사람의 53%에서 비알콜성 지방간을 동반하였다. 4) 대조군과 비알콜성 지방간군에서 대사성 증후군의 각 구성 인자인 당대사이상, 비만, 이상지질혈증 및 고혈압 중 2개 이상의 인자를 갖는 경우는 각각 28%와 73%로 비알콜성 지방간군에서 현저하게 높았다. 결론: 본 연구의 결과는 비알콜성 지방간이 인슐린 저항성과 독립적인 연관성을 가질 가능성을 시사하였고, 비알콜성 지방간이 있는 경우에 당대사이상, 비만, 이상지질혈증 및 고혈압 중 두 가지 이상의 대사성 질환을 가질 확률이 대조군에 비해 약 3배나 높음을 보여주었다. 따라서, 비알콜성 지방간으로 진단된 환자들에서 이러한 대사성 질환들에 대한 적절한 평가와 이를 호전시키기 위한 노력 및 주의 깊은 경과관찰이 필요할 것으로 생각되었다. Background: Non-alcoholic fatty lever disease (NAFLD) is known to be frequently associated with obesity, type 2 diabetes and dyslipidemia. Recently, the diagnosis of fatty lever disease, based on ultrasonographic findings, has increased. Therefore, we examined the association between NAFLD and various metabolic disease, such as obesity, glucose intolerance, dyslipidemia, and hypertension or metabolic syndrome, and tried to find out whether NAFLD was independently related to insulin resistance. Methods: From April to June 2000, 262 subjects, attending for routine physical check-ups, were screened. Of these, 115 one hundred fifteen subjects were studied, with the other 147 excluded due to significant alcohol consumption, evidence of viral or toxic hepatits, significant liver or renal dysfunction, and overt thyroid disease. Fatty lever was diagnosed if the subject had a 'bright' liver on ultrasonographic examination. All diagnoses were made by a singled experienced radiologist. Results: of the 115 subjects. 30(26%) showed NAFLD. 1. Systolic and diastolic blood pressures, body weight, serum total cholesterol, triglyceride, fasting insulin levels, and HOMA IR (homeostasis model assessment insulin resistance index) were higher in the subjects with NAFLD than in the controls. 2. Multiple logistic regression analysis, including age, sex, BMI, waist to hip ratio, fasting serum, glucose, lipids and insulin levels, HOMA IR, and hypertension showed that BMI, total cholesterol and HOMA IR were independently related with NAFLD. 3. 27% of the subjects with NAFLD showed metabolic syndrome, and 53% of subjects with metabolic syndrome had NAFLD. 4. The percentage of subjects who had more than two factors of metabolic syndrome was three times higher in the subjects with NAFLD compared to the controls. Conclusion: These results suggest that NAFLD may be independently related with insulin resistance. Metabolic diseases, such as glucose intolerance, obesity, dyslipidemia and hypertension, were more prevalent in the subjects with NAFLD than in the controls. Therefore, we should try to assess the status of the metabolic disease, and treat them in patients with NAFLD (J Kor Soc Endocrinol 17:526∼534, 2002).
이종호,김성권,차미경,서찬종,하승연,강문보,정중배,서일혜 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.5
Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
제 2 형 당뇨병에서 미세혈관 합병증과 대혈관 합병증의 대비
강문호,이기영,정연실,김홍규,서찬종,송광식,박혜영,이원기 대한당뇨병학회 2001 Diabetes and Metabolism Journal Vol.25 No.2
Background: Type 2 diabetes is a heterogeneous disease. As to its complications, microangiopathy predominantly develop in some patients while macroangiopathy is more predominant in others. Therefore, this study was performed to identify the factors associated with such dissociation. Methods: Type 2 diabetic patients were classified into the macro and microangiopathy groups by carotid intima-medial thickness (IMT) and the presence of severe diabetic retinopathy. Patients with IMT ≤ 0.83 mm and severe NPDR or PDR were assigned to microangiopathy group; those with IMT 0.84 mm and no diabetic retinopathy were assigned to macroangiopathy group. Of 95 patients studied, 14 were classified as microangiopathy group and 20 as macroangiopathy group. Results: When the microangiopathy and macroangiopathy groups were compared, the microangiopathy group were significantly younger at the time of examination and at the onset of diabetes, and had longer duration of diabetes. Percentage of patients receiving insulin treatment was significantly higher and plasma C-peptide significantly lower in the microangiopathy group. However, HDL-cholesterol levels were significantly lower in the macroangiopathy group. Furthermore, the multiple logistic regression analyses revealed that younger onset of type 2 diabetes was an independent factor that was associated with the acceleration of microangiopathy. Conclusion: This study suggests that the age at onset of diabetes is an important independent risk factor that is associated with predominant development of microangiopathy in type 2 diabetic patients.