저항성 운동 트레이닝이 비만 남자 대학생의 신체구성, 인슐린저항성, 성장호르몬 및 인슐린유사성장인자-1에 미치는 영향

김승환(Kim, Seung-Hwan) 한국체육과학회 2019 한국체육과학회지 Vol.28 No.4

The purpose of this study was to examine the effects of 11 weeks of resistance exercise training on body composition, insulin resistance, growth hormone and insulin-like growth factor-1 of obese college male students. Twenty obese college male students were volunteered to participate in this study as subjects, and they were randomly assigned to either resistance exercise training group(n=10) or control group(n=10). The subjects in resistance exercise program for intensity of 65% 1RM, three times per week for 11 weeks, whereas subjects in control were asked to maintain their normal life pattern for the same intervention period. All subjects were asked not to change their physical activity pattern throughout the intervention period. Main results of the present study were as follows: 1) Weight, BMI and % body fat were significantly decreased in resistance exercise training group. 2) Insulin and insulin resistance were significantly decreased in resistance exercise training group. but Insulin and insulin resistance were significantly increased in control group. 3) Growth hormone was significantly increased in resistance exercise training group. 4) Insulin-like growth factor-1 was significantly increased in resistance exercise training group. It was concluded that 11 weeks of resistance exercise training would be beneficial for body composition, Insulin resistance, growth hormone and insulin-like growth factor-1 in obese college male students.

Association between Relative Handgrip Strength and Insulin Resistance in Korean Elderly Men without Diabetes: Findings of the 2015 Korea National Health Nutrition Examination Survey

Kwang-Chae Joo,Da-Hye Son,Jae-Min Park 대한가정의학회 2022 Korean Journal of Family Medicine Vol.43 No.3

Background: Evidence regarding the association between handgrip strength (HGS) and insulin resistance in a non-diabetic population is scarce. This study aimed to investigate the association between relative HGS and insulin resistance in older men without diabetes, using a representative sample of the Korean male population.Methods: The study population comprised 206 participants aged 65–80 years, selected from the 2015 Korea Na-tional Health and Nutrition Examination Survey. Insulin resistance was defined as the upper tertile of the homeo-static model assessment of insulin resistance (HOMA-IR). Odds ratios and 95% confidence intervals for insulin re-sistance were assessed using multiple logistic regression analyses after adjusting for confounding variables.Results: The prevalence of insulin resistance decreased with increasing relative HGS. The prevalence in the T1, T2, and T3 groups was 46.0%, 32.2%, and 26.4%, respectively. Compared with the individuals in the highest tertile of relative HGS, the odds ratio (95% confidence interval) for insulin resistance in individuals in the lowest quartile was 2.82 (1.10–7.21) after adjusting for age, smoking, alcohol consumption, aerobic exercise, resistance exercise, systolic blood pressure, total cholesterol, residential area, household income, and education level.Conclusion: Lower relative HGS was inversely associated with an increased risk of insulin resistance in older Kore-an men without diabetes. In clinical practice, relative HGS, which is a simple and inexpensive tool, could be a use-ful measure for identifying older men with insulin resistance. Moreover, these findings suggest that muscle strengthening exercises should be considered to reduce insulin resistance and increase insulin sensitivity.

건강한 소아에서 렙틴 아디포넥틴 비와 인슐린 저항성의 관계

안계현,김신혜,유은경 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.3

Purpose:Leptin and adiponectin are two representative adipocytokines. Leptin increases, but adiponectin decreases, with obesity and insulin resistance. We aimed to study the relationship between the leptin/adiponectin ratio and insulin resistance in healthy children. Methods:Seventy-seven healthy children (36 boys and 41 girls) were enrolled in this study. Anthropometric measurements were performed, and the percentage of weight for height (%WFH) was calculated in each subject. Fasting plasma levels of glucose, insulin, leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. The free androgen index (FAI) was used as a representative of testosterone bioactivity. The homeostasis model assessment was used to estimate the degree of insulin resistance (HOMA-IR). Results:In the boys, HOMA-IR was significantly correlated with age, pubertal stage, free androgen index (FAI), leptin, and the leptin/adiponectin ratio. HOMA-IR was also significantly related to age, percentage of weight for height (%WFH), pubertal stage, estradiol, leptin, and the leptin/adiponectin ratio in girls. The leptin/adiponectin ratio was independently related to HOMA-IR after adjusting for age, %WFH, and FAI in the boys (P<0.05). The leptin/adiponectin ratio was not independently related to HOMA-IR after adjusting for age, %WFH, and estradiol in girls. Conclusion:In non-obese healthy children, the leptin/adiponectin ratio was significantly correlated with insulin resistance. The leptin/adiponectin ratio was independently related to insulin resistance even after adjusting for age, degree of obesity, and androgen levels in healthy boys. (Korean J Pediatr 2008;51:256-261) Purpose:Leptin and adiponectin are two representative adipocytokines. Leptin increases, but adiponectin decreases, with obesity and insulin resistance. We aimed to study the relationship between the leptin/adiponectin ratio and insulin resistance in healthy children. Methods:Seventy-seven healthy children (36 boys and 41 girls) were enrolled in this study. Anthropometric measurements were performed, and the percentage of weight for height (%WFH) was calculated in each subject. Fasting plasma levels of glucose, insulin, leptin, adiponectin, testosterone, estradiol, and sex-hormone binding globulin (SHBG) were measured. The free androgen index (FAI) was used as a representative of testosterone bioactivity. The homeostasis model assessment was used to estimate the degree of insulin resistance (HOMA-IR). Results:In the boys, HOMA-IR was significantly correlated with age, pubertal stage, free androgen index (FAI), leptin, and the leptin/adiponectin ratio. HOMA-IR was also significantly related to age, percentage of weight for height (%WFH), pubertal stage, estradiol, leptin, and the leptin/adiponectin ratio in girls. The leptin/adiponectin ratio was independently related to HOMA-IR after adjusting for age, %WFH, and FAI in the boys (P<0.05). The leptin/adiponectin ratio was not independently related to HOMA-IR after adjusting for age, %WFH, and estradiol in girls. Conclusion:In non-obese healthy children, the leptin/adiponectin ratio was significantly correlated with insulin resistance. The leptin/adiponectin ratio was independently related to insulin resistance even after adjusting for age, degree of obesity, and androgen levels in healthy boys. (Korean J Pediatr 2008;51:256-261)

HCV : PE-093 ; Insulin resistance in nonalcoholic steatohepatitis associated with metabolic syndrome

( Kyong Yeun Jung ),( Byoung Woon Kwon ),( Yong Hyun Kim ),( Rhan Noh ),( Ha Yan Kang ),( Hyun Deok Shin ),( Suk Bae Kim ),( Il Han Song ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1

Background: Nonalcoholic steatohepatitis (NASH) is regarded as a hepatic manifestation of metabolic syndrome. Insulin resistance has been suggested as an essential requirement of the pathogenic mechanism of NASH. The aims of this study were to determine the association of NASH with the insulin resistance and to assess the correlation of insulin resistance to metabolic components accompanied by patients with NASH. Methods: A total of 89 subjects with NASH (mean age 38±15 year, male 77%) was enrolled, of whom 34 had available quantitative value of insulin resistance. Clinical characteristics including insulin resistance and accompanying metabolic syndrome in NASH subjects were compared with those of 52 diabetes patients (disease controls) and 21 health examinee (normal controls). In NASH patients, the relationship between insulin resistance and metabolic syndrome was analyzed according to the different clustering of metabolic components. Diagnosis of NASH was performed by histology or nonhistologic criteria, and insulin resistance was calculated as homeostasis model assessment of insulin resistance (HOMA-IR). Results: NASH subjects had a stronger association with metabolic syndrome than normal controls. HOMA-IR was significantly higher in NASH patients than that of normal controls (5.1±3.1 vs 1.7±0.6, p<0.001) but not diabetes disease controls (5.1±3.1 vs 4.5±3.2, p>0.05). The proportion of impaired fasting glucose or DM (p=0.002), hypertension (p=0.013), obesity (p=0.023), hypertriglyceridemia (p=0.001), and low HDL cholesterol (p<0.001) significantly increased in accordance with the number of different clustering of accompanying metabolic components in patients with NASH. HOMA-IR was positively correlated with BMI (r=0.432, p=0.014) but not correlated with the other metabolic components. Conclusions: NASH subjects showed increased insulin resistance with significant association of metabolic syndrome. Further prospective study should be challenged for assessing a causal and evolutional relationship in NASH and metabolic syndrome related to insulin resistance.

HCV, Alcoholic : PE-093 ; Insulin resistance in nonalcoholic steatohepatitis associated with metabolic syndrome

( Kyong Yeun Jung ),( Byoung Woon Kwon ),( Yong Hyun Kim ),( Rhan Noh ),( Ha Yan Kang ),( Hyun Deok Shin ),( Suk Bae Kim ),( Il Han Song ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Nonalcoholic steatohepatitis (NASH) is regarded as a hepatic manifestation of metabolic syndrome. Insulin resistance has been suggested as an essential requirement of the pathogenic mechanism of NASH. The aims of this study were to determine the association of NASH with the insulin resistance and to assess the correlation of insulin resistance to metabolic components accompanied by patients with NASH. Methods: A total of 89 subjects with NASH (mean age 38±15 year, male 77%) was enrolled, of whom 34 had available quantitative value of insulin resistance. Clinical characteristics including insulin resistance and accompanying metabolic syndrome in NASH subjects were compared with those of 52 diabetes patients (disease controls) and 21 health examinee (normal controls). In NASH patients, the relationship between insulin resistance and metabolic syndrome was analyzed according to the different clustering of metabolic components. Diagnosis of NASH was performed by histology or non- histologic criteria, and insulin resistance was calculated as homeostasis model assessment of insulin resistance (HOMA-IR). Results: NASH subjects had a stronger association with metabolic syndrome than normal controls. HOMA-IR was significantly higher in NASH patients than that of normal controls (5.1±3.1 vs 1.7±0.6, p<0.001) but not diabetes disease controls (5.1±3.1 vs 4.5±3.2, p>0.05). The proportion of impaired fasting glucose or DM (p=0.002), hypertension (p=0.013), obesity (p=0.023), hypertriglyceridemia (p=0.001), and low HDL cholesterol (p<0.001) significantly increased in accordance with the number of different clustering of accompanying metabolic components in patients with NASH. HOMA-IR was positively correlated with BMI (r=0.432, p=0.014) but not correlated with the other metabolic components. Conclusions: NASH subjects showed increased insulin resistance with significant association of metabolic syndrome. Further prospective study should be challenged for assessing a causal and evolutional relationship in NASH and metabolic syndrome related to insulin resistance.

소아와 청소년에서 Adiponectin과 인슐린 저항성에 관한 연구

김세영,변성환,전제덕,김현수 대한소아내분비학회 2007 Annals of Pediatirc Endocrinology & Metabolism Vol.12 No.1

Purpose : Currently many studies have confirmed the relationship between serum adiponectin and its influence on insulin resistance in adults. But physiologic insulin resistance due to changes in sex hormones exists during puberty, which prohibits us from knowing the influence of adiponectin to insulin resistance in this population. In this study, we investigated the influence of adiponectin on insulin resistance in children and adolescents. Methods : 18 obese children, from the OPD were selected. From All subjects, blood was sampled after overnight fasting, adiponectin, lipid profiles, AST, ALT, fasting glucose and insulin levels were measured to evaluate correlations with adiponectin. The group were divided into subgroups by BMI, sex and HOMA-IR values. All variables were compared for differences and relationships. Results : Obese groups showed decrease in adiponectin and showed increased insulin. HOMA-IR values were increased in the obese group. In all study participants, adiponectin showed significant correlation with triglyceride and HDL. But adiponectin showed no significant correlation with HOMA-IR, insulin and glucose. In the obese group adiponectin showed no correlation with HOMA-IR, insulin and glucose. HOMA-IR showed significant correlation with BMI, body weight and age. There were no sexual differences in adiponectin, insulin and HOMA-IR values. Insulin resistant group showed decrease in adiponectin but had no statistical significance. Conclusion : Decreased adiponectin levels and increased insulin resistance were observed in obese children but adiponectin showed no correlation with insulin resistance in children and adolescence. Factors other than adiponectin may play a more significant role in insulin resistance in this age group. 목 적 : 성인의 연구에서 adiponectin과 인슐린 저항성과의 관계는 여러 연구에서 보였다. 그러나 소아청소년기에는 사춘기 때 여러 변화로 나타나는 생리적인 인슐린 저항성이 있어 adiponectin이 실제로 어느 정도 기여하는지에 대하여 불분명하였다. 본 연구에서는 소아청소년기에 나타나는 인슐린 저항성이 adiponectin과 연관성이 있는지에 대하여 조사하였다. 방 법 : 2005년 2월 1일부터 2005년 8월 30일까지 7개월 동안 분당제생병원 소아과 외래로 내원 또는 입원치료 받았던 환자 38명에게서 혈액을 채취하여 혈청 adiponectin과 인슐린을 구하였고 그 외 다른 변수들을 구하여 이들을 BMI, 성별, 인슐린 저항성 그룹에 따라 나누어 비교하였다. 결 과 : BMI로 나눈 비만군(BMI 95백분위수 이상)과 대조군(정상 BMI)에서 혈청 adiponectin (대조군 12.7±10.4 vs. 비만군 6.3±3.8, P<0.05)은 비만군에서 현저하게 줄어들어 있었다. 인슐린(대조군 11.1±8.2 vs. 비만군 39.8±53.6, P<0.05)은 비만군에서 현저히 높아져 있었으며 HOMA-IR (대조군 2.4±1.8 vs. 비만군 9.8±14.7, P<0.05)도 이와 비례하여 높아져 있었다. Adiponectin은 혈중 중성지방과 HDL-콜레스테롤과 통계학적 연관성을 가지고 있었다. 그러나 인슐린 저항성과의 상관관계는 보이지 않았다. 인슐린의 경우 나이, 키, 몸무게, BMI, ALT, AST/ ALT 비, 혈당과 연관성을 보였다. 나이에서는 비만군과 대조군을 같이 표시하였는데 나이가 들어가면서 인슐린의 농도가 증가하는 양상을 보였다(P<0.05, r=0.115). 비만군(18명)에서는 adiponectin은 다른 변수들과 유의한 상관관계를 보이지 않았다. 남자는 총 19명, 여자는 총 19명이었으며 혈청 adiponectin (남자 7.3±5.1 vs. 여자 7.9±6.3, P=0.74)과 인슐린 (남자 39.8±53.6 vs. 여자11.1±8.2, P= 0.41), HOMA-IR (남자 6.8±10.3 vs. 여자5.0±11.4, P= 0.60)은 두 성별에서 뚜렷한 차이를 보이지 않았다. HOMA-IR 값이 3이상인 집단은 총16명이었으며 3이하인 집단은 22명이었다. 혈청 adiponectin은 인슐린 저항성 집단에서 감소되어 있었지만 통계학적으로 유의한 차이를 보이지 않았다(인슐린 저항성 집단 6.3±5.4 vs. 대조군 8.6±5.9, P=0.23). 결 론 : 소아청소년에서 나타나는 인슐린 저항성은 비만군에서 더 뚜렷한 양상을 보였고 혈청 adiponectin 역시 비만군에서 더 감소되어 있었으나 둘 사이의 통계학적 연관성은 없었는데 이는 소아청소년기에 성호르몬의 영향으로 나타나는 생리적인 인슐린 저항성 등의 다른 요인들이 adiponectin보다 더 큰 영향을 미치는 것으로 생각된다.

Quantitative secretome and glycome of primary human adipocytes during insulin resistance

Lim, Jae-Min,Wollaston-Hayden, Edith E,Teo, Chin Fen,Hausman, Dorothy,Wells, Lance Springer 2014 Clinical proteomics Vol.11 No.1

<P>Adipose tissue is both an energy storage depot and an endocrine organ. The impaired regulation of the secreted proteins of adipose tissue, known as adipocytokines, observed during obesity contributes to the onset of whole-body insulin resistance and the pathobiology of type 2 diabetes mellitus (T2DM). In addition, the global elevation of the intracellular glycosylation of proteins by O-linked β-N-acetylglucosamine (O-GlcNAc) via either genetic or pharmacological methods is sufficient to induce insulin resistance in both cultured cells and animal models. The elevation of global O-GlcNAc levels is associated with the altered expression of many adipocytokines. We have previously characterized the rodent adipocyte secretome during insulin sensitive and insulin resistant conditions. Here, we characterize and quantify the secretome and glycome of primary human adipocytes during insulin responsive and insulin resistant conditions generated by the classical method of hyperglycemia and hyperinsulinemia or by the pharmacological manipulation of O-GlcNAc levels. Using a proteomic approach, we identify 190 secreted proteins and report a total of 20 up-regulated and 6 down-regulated proteins that are detected in both insulin resistant conditions. Moreover, we apply glycomic techniques to examine (1) the sites of N-glycosylation on secreted proteins, (2) the structures of complex N- and O-glycans, and (3) the relative abundance of complex N- and O-glycans structures in insulin responsive and insulin resistant conditions. We identify 91 N-glycosylation sites derived from 51 secreted proteins, as well as 155 and 29 released N- and O-glycans respectively. We go on to quantify many of the N- and O-glycan structures between insulin responsive and insulin resistance conditions demonstrating no significant changes in complex glycosylation in the time frame for the induction of insulin resistance. Thus, our data support that the O-GlcNAc modification is involved in the regulation of adipocytokine secretion upon the induction of insulin resistance in human adipocytes.</P>

폐경 여성에서 인슐린저항성의 예측인자

최희정 ( Hee Jeong Choi ),윤경은 ( Kyung Eun Yun ) 대한폐경학회 2010 대한폐경학회지 Vol.16 No.2

연구목적: 이 연구는 폐경 후 여성에서 비만, 높은 alanine aminotransferase (ALT)와 인슐린저항성 간에 연관성을 알아보고, 대사증후군과 비교하여 이들 두 요인이 인슐린저항성을 예측하는 정도를 비교하기 위해 시행하였다. 연구재료 및 방법: 이 연구는 건강증진센터를 방문한 606명의 폐경 후 여성을 대상으로 하였다. 설문지와 문진을 통해 병력과 생활습관에 대해 조사하였고 신체계측과 혈압을 측정하였다. 검사실 검사로는 공복 혈당과 인슐린, 간 기능검사, 지질 검사 등을 하였고, 혈당과 인슐린 농도를 이용하여 호마지수를 계산하였다. 대사증후군은 NCEP-ATP III의 정의에 따라 분류하였다. 호마지수를 사분위수로 나누어 최고 사분위수에 해당하는 군을 인슐린저항성이 있는 군으로 정의하여 각 요인의 인슐린저항성에 대한 교차비를 구하였다. 결과: 비만과 높은 ALT의 빈도는 호마지수가 높을수록 의미 있게 증가하였다. 연령, 흡연, 운동을 보정하고 비만과 높은 ALT는 각각 인슐린저항성의 위험을 의미 있게 증가시켰으며, 비만과 높은 ALT을 모두 가지는 여성 (OR=5.87; 95% CI 2.93∼11.74)은 대사증후군이 있는 여성 (OR=3.43; 95% CI 2.18∼5.41)에 비해 인슐린저항성의 위험이 더 높은 것으로 나타났다. 결론: 폐경 후 여성에서 비만과 높은 ALT는 인슐린저항성과 연관이 있으며, 이 두 요인이 모두 있는 경우 대사증후 군보다 인슐린저항성을 더 잘 예측할 수 있는 것으로 나타났다. Objectives: Insulin resistance plays an important role in cardiovascular diseases, type 2 diabetes, and non-alcoholic fatty liver disease. The objective of this study was to determine the association between obesity and elevated alanine aminotransferase (ALT) with insulin resistance and compare these factors with metabolic syndrome in postmenopausal women. Methods: We analyzed 606 postmenopausal women who had visited the Health Promotion Center. The medical history and lifestyle data were collected by questionnaire and history taking. Anthropometric parameters and blood pressure were measured. Laboratory tests included fasting glucose and insulin levels, and liver and lipid profiles. Metabolic syndrome was defined based on NCEP-ATP III criteria. As a maker of insulin resistance, the homeostatic model assessment-insulin resistance (HOMA-IR) was calculated. We grouped all subjects into four groups, based on the quartiles of HOMA-IR. The top fourth quartile group was defined as the group with insulin resistance. We performed multivariate logistic regression analysis for the odds ratio of the risk for insulin resistance. Results: The prevalence rates of obesity (body mass index ≥ 25 kg/㎡) and elevated ALT (≥ 34 U/L) increased with increased HOMA-IR. Obesity and elevated ALT were associated with insulin resistance, after adjusting for age, smoking status, and exercise. Women with co-existing obesity and elevated ALT were at increased risk for insulin resistance (OR=5.87; 95% CI, 2.93∼11.74) compared to women with metabolic syndrome (OR=3.43; 95% CI, 2.18∼5.41). Conclusion: Obesity and elevated ALT are associated with insulin resistance in postmenopausal women. A combination of these factors is superior to metabolic syndrome in predicting insulin resistance.

Clearance of HCV by Combination Therapy of Pegylated Interferon α-2a and Ribavirin Improves Insulin Resistance

( Hong Joo Kim ),( Jung Ho Park ),( Dong Il Park ),( Yong Kyun Cho ),( Chong Il Sohn ),( Woo Kyu Jeon ),( Byung Ik Kim ) 대한소화기기능성질환·운동학회 2009 Gut and Liver Vol.3 No.2

Background/Aims: Chronic hepatitis C virus (HCV) infection is associated with a higher risk of the development of insulin resistance. If HCV is a causal factor for insulin resistance, then clearance of HCV might decrease insulin resistance. The aim of this study was to elucidate the effects of clearance of HCV on insulin resistance. Methods: We analyzed 28 patients with HCV infection who received combination treatment of 180 μg of pegylated interferon α-2a and ribavirin at our institution from May 2004 to November 2006. Insulin resistance was calculated according to the homeostasis model assessment of insulin resistance (HOMA-IR) method. Results: Twenty-two patients (78.6%) achieved sustained virologic response (SVR), where the fasting plasma glucose level significantly decreased after antiviral treatment. Fasting serum insulin and HOMA-IR also significantly decreased after antiviral treatment, whereas the BMI value was not significantly affected. For the nonresponders (n=6), no significant changes were evident in BMI, fasting plasma glucose, fasting serum insulin, and HOMA-IR at 6 months after the end of antiviral treatment. Logistic regression analysis indicated that the only independent factor contributing to the reduction of insulin resistance was the complete disappearance of HCV RNA at 6 months after the end of antiviral treatment (SVR). Conclusions: The clearance of HCV by the combination therapy of pegylated interferon α-2a and ribavirin improves insulin resistance by reducing fasting serum insulin and glucose levels. (Gut and Liver 2009;3:108-115)

Review : Molecular Mechanism of Insulin Resistance in Obesity and Type 2 Diabetes

( Kang Duk Choi ),( Young Bum Kim ) 대한내과학회 2010 The Korean Journal of Internal Medicine Vol.25 No.2

Insulin resistance is a major risk factor for developing type 2 diabetes caused by the inability of insulin-target tissues to respond properly to insulin, and contributes to the morbidity of obesity. Insulin action involves a series of signaling cascades initiated by insulin binding to its receptor, eliciting receptor autophosphorylation and activation of the receptor tyrosine kinase, resulting in tyrosine phosphorylation of insulin receptor substrates (IRSs). Phosphorylation of IRSs leads to activation of phosphatidylinositol 3-kinase (PI3K) and, subsequently, to activation of Akt and its downstream mediator AS160, all of which are important steps for stimulating glucose transport induced by insulin. Although the mechanisms underlying insulin resistance are not completely understood in skeletal muscle, it is thought to result, at least in part, from impaired insulin-dependent PI3K activation and downstream signaling. This review focuses on the molecular basis of skeletal muscle insulin resistance in obesity and type 2 diabetes. In addition, the effects of insulin-sensitizing agent treatment and lifestyle intervention of human insulin-resistant subjects on insulin signaling cascade are discussed. Furthermore, the role of Rho-kinase, a newly identified regulator of insulin action in insulin control of metabolism, is addressed. (Korean J Intern Med 2010;25:119-129)