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According to recent genome-wide association studies, a number of single nucleotide polymorphisms (SNPs) are reported to be associated with type 2 diabetes mellitus (T2DM). The aim of the present study was to investigate the association among the polymorphisms of SLC30A8, HHEX, CDKN2A/B, IGF2BP2, FTO, WFS1, CDKAL1 and KCNQ1 and the risk of T2DM in the Korean population. This study was based on a multicenter casecontrol study, including 908 patients with T2DM and 502 non-diabetic controls. We genotyped rs13266634, rs1111875, rs10811661, rs4402960, rs8050136, rs734312, rs7754840 and rs2237892 and measured the body weight, body mass index and fasting plasma glucose in all patients and controls. The strongest association was found in a variant of CDKAL1 [rs7754840, odds ratio (OR) = 1.77, 95% CI = 1.50-2.10, p = 5.0 9 10-11 ]. The G allele of rs1111875 (OR = 1.43, 95% CI = 1.18-1.72, p = 1.8 9 10 -4 ) in HHEX), the T allele of rs10811661 (OR = 1.47, 95% CI = 1.23-1.75, p = 2.1 9 10 -5 ) in CDKN2A/B) and the C allele of rs2237892 (OR = 1.31, 95% CI = 1.10-1.56, p = 0.003) in KCNQ1 showed significant associations with T2DM. Rs13266634 (OR = 1.19, 95% CI = 1.00-1.42, p = 0.045) in SLC30A8 showed a nominal association with the risk of T2DM, whereas SNPs in IGF2BP2, FTO and WFS1 were not associated. In conclusion, we have shown that SNPs in HHEX, CDKN2A/B, CDKAL1, KCNQ1 and SLC30A8 confer a risk of T2DM in the Korean population.

IntroductionThe relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT) is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.MethodThis retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.ResultsThe mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15%) patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069). In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37–80.93, p = 0.024).ConclusionSarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.

We investigated the cytokines and mechanisms involved in the induction of insulin resistance in human skeletal muscle. Ten subjects with impaired glucose tolerance (IGT) and 10 control subjects were recruited. We performed biopsies on the vastus lateralis muscle and used immunoblotting to determine levels of inflammatory cytokines, Toll-like receptor (TLR) gene expression, and insulin signaling. We also used a human myotube culture system to examine the mechanisms underlying TLR-4 gene expression. To identify inflammatory cytokines associated with insulin resistance, we measured the levels of IL-6, TNF-α, TLR-2, and TLR-4 in skeletal muscle from non-obese patients with IGT and control subjects. Levels of IL-6, TNF-α, and TLR-4, but not TLR-2, were significantly increased in the IGT group. Insulin resistance decreased significantly in HSMMs following long-term IL-6 treatment. TLR-4 gene expression was significantly increased in human skeletal muscle myoblasts (HSMMs) treated with IL-6. To determine the main signaling pathway for IL-6-induced TLR-4 gene expression, we examined several signaling factors associated with IL-6 signaling pathways. We found that the active form of "signal transducer and activator of transcription 3" (STAT3) was increased. "Stattic" (a STAT3 inhibitor) markedly inhibited TLR-4 gene expression. IL-6 induction of TLR-4 gene expression via STAT3 is one of the main mechanisms underlying insulin resistance in human skeletal muscle.

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