OBJECTIVEWe examined prevalence of sarcopenia in Korean patients with type 2 diabetes and compared body compositional parameters between subjects with and without type 2 diabetes.RESEARCH DESIGN AND METHODSThe Korean Sarcopenic Obesity Study (KSOS) included 810 subjects (414 patients with diabetes and 396 control subjects) who were examined using dual-energy X-ray absorptiometry. Prevalence of sarcopenia was defined using the skeletal muscle index (SMI).RESULTSPrevalence in patients with diabetes and in the control group was 15.7 and 6.9%, respectively. In both men and women, SMI values were significantly decreased in patients with diabetes compared with subjects without diabetes. Furthermore, multiple logistic regression analysis showed that type 2 diabetes was independently associated with sarcopenia.CONCLUSIONSType 2 diabetes was associated with increased risk of sarcopenia. These characteristics may contribute to physical disability and metabolic disorders in older adults with diabetes.

Previous studies have shown that nonalcoholic fatty liver disease (NAFLD) and sarcopenia may share pathophysiological mechanisms, such as insulin resistance, inflammation, vitamin D deficiency, and decreased physical activity. However, their direct relationship has not been investigated. The association between NAFLD and sarcopenia was examined in 452 apparently healthy adults enrolled in the Korean Sarcopenic Obesity Study (KSOS), an ongoing prospective observational cohort study. The liver attenuation index (LAI), which was measured using abdominal computed tomography (CT), was used as a parameter for the diagnosis of NAFLD. Sarcopenia was defined using a skeletal muscle mass index (SMI) [SMI (%) 5 total skeletal muscle mass (kg) / weight (kg) 3 100] that was measured by dual energy X-ray absorptiometry (DXA). After adjusting for age and sex, both SMI and LAI were negatively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) (P < 0.001) and high sensitivity C-reactive protein (hsCRP) (P < 0.001) as well as brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness. Furthermore, SMI and LAI had positive relationships with high-density lipoprotein (HDL)-cholesterol, but both had a negative relationship with triglyceride, alanine aminotransferase (ALT), and total body fat. In a multiple logistic regression analysis, the odds ratio for NAFLD risk was 5.16 (95% confidence interval [CI] 5 1.63-16.33) in the lowest quartile of SMI compared to the highest after adjusting for potential confounding factors. Conclusion: Individuals with lower muscle mass exhibited increased risk of NAFLD. This result may provide a novel insight into the mechanism linking between sarcopenia and NAFLD.

OBJECTIVE -The International Diabetes Mellitus Practice Study is a 5-year survey documenting changes in diabetes treatment practice in developing regions.RESEARCH DESIGN AND METHODS -Logistic regression analysis was used to identify factors for achieving A1C Ͻ7% in 11,799 patients (1,898 type 1 diabetic and 9,901 type 2 diabetic) recruited by 937 physicians from 17 countries in Eastern Europe (n ϭ 3,519), Asia (n ϭ 5,888), Latin America (n ϭ 2,116), and Africa (n ϭ 276).RESULTS -Twenty-two percent of type 1 diabetic and 36% of type 2 diabetic patients never had A1C measurements. In those with values for A1C, blood pressure, and LDL cholesterol, 7.5% of type 1 diabetic (n ϭ 696) and 3.6% of type 2 diabetic (n ϭ 3,896) patients attained all three recommended targets (blood pressure Ͻ130/80 mmHg, LDL cholesterol Ͻ100 mg/dl, and A1C Ͻ7%). Selfmonitoring of blood glucose was the only predictor for achieving the A1C goal in type 1 diabetes (odds ratios: Asia 2.24, Latin America 3.55, and Eastern Europe 2.42). In type 2 diabetes, short disease duration (Asia 0.97, Latin America 0.97, and Eastern Europe 0.82) and treatment with few oral glucose-lowering drugs (Asia 0.64, Latin America 0.76, and Eastern Europe 0.62) were predictors. Other region-specific factors included lack of microvascular complications and old age in Latin America and Asia; health insurance coverage and specialist care in Latin America; lack of obesity and self-adjustment of insulin dosages in Asia; and training by a diabetes educator, self-monitoring of blood glucose in patients who self-adjusted insulin, and lack of macrovascular complications in Eastern Europe.CONCLUSIONS -In developing countries, factors pertinent to patients, doctors, and health care systems all impact on glycemic control. Diabetes Care 32:227-233, 2009A lthough optimizing diabetes care reduces death and complication rates (1-3), multiple barriers hinder turning evidence into practice (4,5). Most diabetic patients reside in developing countries (6) where standardized data on quality of care is relatively scarce. The International Diabetes Management Practices Study (IDMPS) is an ongoing observational survey to collect, analyze, and disseminate data in a standardized manner. By documenting changes in practices over time in a broad range of health care settings, we aim to raise awareness and identify barriers to quality diabetes care. Other objectives include evaluation of clinical progress, levels of compliance, attainment of treatment targets, and rates of hospitalization and work absenteeism. This analysis of the first-year survey examines factors predictive of glycemic control.RESEARCH DESIGN AND METHODS -There are five waves in this 5-year study, each consisting of a 2-week cross-sectional and a 9-month longitudinal survey. A 3-month interval separates the end of the longitudinal survey and the start of the next wave. Study design and reporting format are in accordance with the recommended STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guideline...

At the population level, evening chronotype was independently associated with diabetes, metabolic syndrome, and sarcopenia. These results support the importance of circadian rhythms in metabolic regulation.

Insulin resistance, inflammation and vitamin D deficiency were associated with SO in a Korean adult population.

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OBJECTIVE -The purpose of this study was to estimate the prevalence of diabetes and impaired fasting glucose (IFG) and their association with risk factors in the Korean population. RESEARCH DESIGN AND METHODS -The Korean National Health and NutritionSurvey 2001 was a nationally representative survey with a stratified multistage sampling design. Data from a comprehensive questionnaire, a physical examination, and blood tests were obtained from 5,844 Korean adults (2,513 men and 3,331 women) aged Ͼ20 years.RESULTS -The age-adjusted prevalence of diabetes in this Korean population was 7.6%, and the age-adjusted prevalences of previously diagnosed diabetes and newly diagnosed diabetes were 4.4 and 3.3%, respectively (fasting plasma glucose Ն7.0 mmol/l). Overall, these results indicate that 8.1% or 1.4 million Korean men and 7.5% or 1.3 million Korean women have diabetes. The age-adjusted prevalence of IFG was 23.9%, using the new American Diabetes Association criteria (fasting plasma glucose 5.6 -6.9 mmol/l). Diabetes prevalence increased with age and peaked in the oldest age-group; however, IFG prevalence did not show the same trend. Diabetes was found to be associated with age, BMI, blood pressure, triglyceride, HDL cholesterol, education levels, alcohol consumption, exercise, and a family history of diabetes.CONCLUSIONS -This study shows that diabetes and IFG are common in Korea, and about one-half of diabetes cases remain undiagnosed. These results emphasize the need to develop an urgent public program to improve the detection, prevention, and treatment of diabetes. Diabetes Care 29:226 -231, 2006T ype 2 diabetes is recognized as a global health problem nowadays, and it has been projected that the number of diabetic patients will rise from an estimated 135 million in 1995 to 300 million in 2025 (1). Moreover, the AsiaPacific region is considered to be on the verge of an emerging diabetes epidemic (2).Individuals with diabetes have a higher risk of complications such as retinopathy, nephropathy, neuropathy, and cardiovascular disease (3). According to the Korea National Statistical Office, the mortality rate due to diabetes was 25.0 per 100,000 persons in 2003, and thus it is currently rated as Korea's fourth leading cause of death (4). Although the importance of early diagnosis and secondary intervention programs for the prevention of diabetes complications have been emphasized, about one-half of those with diabetes remain unidentified (5). Epidemiological studies on diabetes have a significant impact on diabetes research, care, and prevention programs. The prevalence of diabetes varies widely among populations according to race, lifestyle, and urbanization (6). In a recent survey in the U.S., its prevalence was 8.2% in adults aged 20 -74 years (7). In Korea, a number of studies have been conducted on diabetes prevalence, including one by the present authors (8 -10). However, previous studies have been regionally based, and thus reliable nationwide data about the prevalence of diabetes and impaired fasting gluco...

Objectives: Previous studies have revealed that both short and long sleep durations are linked to obesity, hyperglycemia and hypertension. We evaluate the relationship between sleep duration and the metabolic syndrome using representative national survey data from the Korean population. Methods: We analyzed data from the 2001 Korean National Health and Nutrition Survey. The average amount of sleep per night was categorized as: p5, 6, 7, 8 and X9 h. Those reporting 7 h per night served as a reference group. In this cross-sectional study, the data of 4222 participants were finally analyzed. Results: A majority of the components of the metabolic syndrome demonstrated U-shaped patterns based on sleep duration. Although the prevalences of abdominal obesity and hypertension were highest in subjects who slept p5 h per night, those of hyperglycemia and high triglyceridemia were highest in subjects who slept X9 h per night. Prevalence of the metabolic syndrome also exhibited U-shape pattern based on sleep duration. More components of the metabolic syndrome were highly associated with sleep duration in subjects under the age of 60 compared to those over the age of 60. Subjects who slept p5 h per night demonstrated the highest risk for the metabolic syndrome (OR 1.74, 95% CI 1.33-2.26, Po0.001). Subjects who slept X9 h per night exhibited increased risk for the metabolic syndrome even after adjustment of other risk variables (OR 1.69, 95% CI 1.17-2.45, P ¼ 0.006). Conclusions: Both short and long sleep durations are related to increased risk of the metabolic syndrome and its components in the Korean population, although adjustment for risk factors attenuates their relationship. Subjects reporting sleep duration of 7 h demonstrated the lowest prevalence of the metabolic syndrome.