Neurocognitive Function Impairment in Alcohol Dependent Patients with Diabetes Mellitus / 신경정신의학

OBJECTIVES: Diabetes and alcohol dependence are considered as independent risk factors for cognitive impairment. This research was to investigate whether cognitive functions in diabetic alcohol dependent patients were more impaired than non-diabetic alcohol dependent patients. METHODS: A cross-sectional study was conducted in alcohol dependence patients (n=138). Patients with alcohol dependence diagnosed by Diagnostic and Statistical Manual of Mental Disorder, 4th edition, Text Revision underwent a 75 g oral glucose tolerance test, to classify to diabetics group and non-diabetics group. In addition to demographic and clinical characteristics, cognitive functions assessed using the Korean-Mini Mental Status Examination (K-MMSE), word list memory test, and word fluency test, word list recall test from Korean version of the consortium to establish a registry for Alzheimer's disease, and block design test, digit span test, and digit symbol test from Korean-Wechsler Adult Intellogence Scale were compared between the two groups. RESULTS: There was no significant difference in demographic and other clinical characteristics between the non-diabetic and diabetic alcoholic patients. Compared to non-diabetic alcoholic patients, diabetic alcoholic patients were more impaired on language of K-MMSE (p=0.028) and digit symbol test (p=0.044). CONCLUSION: These findings suggest the more severe impairment of selective cognitive functions in diabetic alcoholic patients than non-diabetic alcoholic patients. Future replication of these findings in a large population is necessary.

The Changes of Blood Glucose Control and Lipid Profiles after Short-Term Smoking Cessation in Healthy Males

OBJECTIVE: Our aim was to evaluate the changes in blood glucose control and lipid profiles after 2-months of smoking cessation in healthy males. METHODS: Smoking abstinence was evaluated through self-report and urine cotinine levels. 12 individuals who succeeded in quitting smoking were analyzed. Fasting values of glucose and insulin were used to estimate the beta-cell activity and insulin resistance was evaluated using the Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI). RESULTS: The data showed that the subjects had a significant increase in weight, body mass index and fasting plasma glucose levels after smoking cessation. The HOMA-Insulin Resistance and the HOMA beta-cell function increased significantly (p=0.005, p=0.047 respectively). The QUICKI showed a significant decrease (p=0.005). In addition, the low-density lipoprotein cholesterol levels decreased significantly (p=0.028); however, changes in the high-density lipoprotein cholesterol, the triglyceride and total cholesterol levels were not significant (p=0.284, p=0.445 respectively). CONCLUSION: During the initial stage of smoking abstinence, insulin resistance increased and insulin sensitivity decreased due to elevated body weight and fat composition. Therefore, it is important to educate individuals that stop smoking about the necessity of weight control during smoking cessation programs.