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￭♣ S-397 ￭
Clinical Characteristics According to the Use of Metformin in Korean Type 2 Diabetic Patients
1경희의대 내분비대사내과, 2성균관의대 융합기술원, 3단국의대 내분비대사내과, 4고려의대 내분비대사내과, 5한양의대 내분비대사내과,
6인하의대 내분비대사내과, 7아주의대 내분비대사내과
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하인균
1, 이상열
1, 한승우
1, 조성권
2, 전 숙
1, 김성훈
3, 안규정
1, 백세현
4, 박용수
5, 남문석
6, 이관우
7, 우정택
1Background: Metformin has been used as a first-line treatment in diabetic patients, but it has not been used as a first-line treatment in some patients.
This study was designed to identify the clinical characteristics of Korean patients with type 2 diabetes mellitus (T2DM) with metformin use and to un- derstand the determinants of metformin use in clinical practice. Methods: This study was conducted using the baseline data of prospective, multicenter clinical registry collected from 7 university hospitals in Korea. Subjects who have no significant changes in the use of diabetes related medication, and no diabetes related acute and chronic complications within one year of participation, were registered in the registry. The clinical characteristics of pa- tients according to metformin use were analyzed. Results: A total of 858 subjects were included in the analysis. Of these, 706 were metformin users and 152 were non-metformin users. Patients with metformin had significantly higher waist circumference (p＝0.004), hip circumference (p＝0.002) and glycated hemoglobin (p＝0.002) than patients without metformin. Lipid profile (LDL, p＜0.001) and creatinine (p＜0.001) were significantly lower. Particularly, metformin non-users were significantly more likely to have microvascular complications such as retinopathy (p＝0.008), cataract (p
＜0.001), overt proteinuria (p＝0.003), renal failure (p＜0.001), and peripheral neuropathy (p＜0.001) compared to metformin users. Notably, there was a significantly lower prevalence of malignancy (p＝0.008) and depression (p＝0.039) in metformin users. These results were remained significant after multivariate analyses. On the other hand, there was no significant difference in prevalence of macrovascular complication. Conclusion: There were significant differences in clinical characteristics and prevalence of comorbidities according to the use of metformin in Korean T2DM patients.
Long-term follow-up will be conducted on how this difference will affect the clinical course of T2DM patients.
￭♣ S-398 ￭
Vitamin D deficiency is related with NAFLD and visceral fat accumulation in type 2 diabetes mellitus
부천 순천향대학교부속병원 내분비대사내과
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노형균, 김보연, 최덕현, 목지오, 김철희, 강성구
Objectives: Many investigations imply that vitamin D deficiency may develop insulin resistance, metabolic syndrome, and more recently non-alco- holic fatty liver disease (NAFLD). This study assesses prevalence of NAFLD and visceral fat accumulation in type 2 diabetes mellitus related with se- rum vitamin D level. Methods: Total 268 patients were recruited. Abdominal subcutaneous fat thickness (SFT), visceral fat thickness (VFT) and NAFLD were examined by ultrasonography. All patients were divided into three groups ; vitamin D sufficient[25(OH)D≥20 ng/mL], vitamin D in- sufficient [10≤25(OH)D＜20] and vitamin D deficient [25(OH)D＜10] groups. Results: VFT was much higher in vitamin D deficient group than other groups. There were no differences in glycemic control, the body mass index (BMI) and SFT according to serum vitamin D level. The prevalence of NAFLD was higher in vitamin D deficient group compared to vitamin D sufficient and vitamin D insufficient group (36.4% vs 64.0% vs 75.0%, p＝
0.001). The mean levels of 25(OH)D are 13.6±10.4 ng/mL and 2.6±10.9 in type 2 diabetic patients with or without NAFLD, respectively. In multi- variate logistic analysis, after adjustment for age, sex, BMI, diabetes duration and HOMA-IR, type 2 diabetic patients with vitamin D levels of suffi- ciency (25(OH)D≥20 ng/mL) showed significantly lower odd ratio for NAFLD than those with vitamin D levels of deficiency (25(OH)D＜10 ng/mL) [odds ratio＝0.167 (0.042-0.660), p＝0.011]. Conclusion: Vitamin D deficiency is associated with prevalence of NAFLD and visceral fat accumu- lation in type 2 diabetes mellitus. As for now, further studies are required to precisely explain the associated mechanism.
