Diabetes, a chronic hyperglycemic condition, is caused by insufficient insulin secretion or functional impairment. Long-term inadequate regulation of blood glucose levels or hyperglycemia can lead to various complications, such as retinopathy, nephropathy, and cardiovascular disease. Recent studies have explored the molecular mechanisms linking diabetes to bone loss and an increased susceptibility to fractures. This study reviews the characteristics and molecular mechanisms of diabetes-induced bone disease. Depending on the type of diabetes, changes in bone tissue vary. The molecular mechanisms responsible for bone loss in diabetes include the accumulation of advanced glycation end products (AGEs), upregulation of inflammatory cytokines, induction of oxidative stress, and deficiencies in insulin/IGF-1. In diabetes, alveolar bone loss results from complex interactions involving oral bacterial infections, host responses, and hyperglycemic stress in periodontal tissues. Therapeutic strategies for diabetes-induced bone loss may include blocking the AGEs signaling pathway, decreasing inflammatory cytokine activity, inhibiting reactive oxygen species generation and activity, and controlling glucose levels; however, further research is warranted.

Salivary gland dysfunction is a common complication of diabetes. Decreased saliva production and changes in saliva composition may cause oral diseases. Reactive oxygen species (ROS) generation in the salivary glands results in the loss of acinar cells and decreased saliva secretion. Glucagon-like peptide 1 (GLP-1) is the incretin hormone that regulates blood glucose level and can suppress ROS production and inflammation through its antioxidant effects. Dipeptidyl peptidase-4 (DPP-4) is an enzyme that breaks down GLP-1. In this study, we evaluated the pathological role of DPP-4 and GLP-1 on salivary gland dysfunction in type 2 diabetic db/db mice. We observed reduced salivary secretion and histopathological alteration of salivary glands in the db/db mice. The increased DPP-4 and decreased GLP-1 levels in the salivary glands were also detected in the db/db mice. Furthermore, the db/db mice had increased apoptosis and oxidative injury in salivary glands. There was an accumulation of advanced glycation end products and mucus in the salivary glands of the db/db mice. In conclusion, these results showed the possible involvement of DPP-4 and GLP-1, leading to increased ROS-induced apoptosis in diabetes-related salivary gland dysfunction. DPP-4 and GLP-1 may be a pharmacological target for patients with diabetes-related salivary gland dysfunction.

초파리를 당뇨병을 연구하는데 사용하는 경우가 많으나 당뇨병이 유전적 요인에 작용하여 다음 세대에 미치 는 영향을 다루고 있는 연구는 적다. 따라서 본 연구에서는 초파리에 고당도의 먹이를 통해 당뇨병을 유발하고, 류신(leucine)의 당뇨병에 대한 치료효과를 확인하고 다음 세대에 미치는 영향을 알아보고자 했다. 본 연구에서 는 Drosophila melanogaster를 초파리 모델에 사용했다. 먹이에 고농도의 설탕, 고농도의 설탕과 류신을 첨가하여 당뇨의 발병과 당뇨병의 치료효과를 확인했다. 당뇨병의 발병을 확인하기 위해 초파리의 체내의 포도당을 측정 하여 대조군에 비해서 고농도의 설탕을 섭취한 경우에 포도당의 농도는 증가했고, 류신을 섭취한 경우에는 포도 당이 대조군에 비해서도 급격히 떨어지는 것을 확인했다. 고농도의 설탕이 포함된 먹이 조건을 유지하고 교배를 통해 자손을 얻고자 하였다. 그 결과, 고농도의 설탕을 섭취한 경우 자손의 몸의 크기가 0.1mm 정도 감소하고 무게 또한 감소했다. 그러나 고농도의 설탕과 류신을 섭취한 경우 자손을 얻지 못했다. 당뇨병을 유발시킨 초파리 를 이용해 류신과 운동의 효과를 동시에 확인했다. 당뇨병이 유발된 경우 운동만으로는 포도당의 감소에 영향을 주지 못하였으나, 류신 운동을 병행한 경우에는 포도당이 감소했고 수컷 초파리에서 잘 관찰되었다. 운동과 류신 섭취를 병행하는 실험에서는 당뇨병을 유발한 초파리의 자손을 사용했기 때문에 크기는 당뇨병을 유발하지 않은 것보다 작았다. 따라서 초파리의 당뇨병 모델을 통해서 당뇨병이 유전적으로 전달되며 Leucine에 의한 치료 는 성충에 수행되는 것이 효과적임을 알 수 있었다.

A 12-year-old intact female Schnauzer was referred for the evaluation of poorly controlled diabetes mellitus: despite insulin therapy, blood glucose concentration was consistently high, indicating a decreased insulin sensitivity. Laboratory analyses revealed persistent hyperglycemia, glucosuria, and ketonuria. Diagnostic approaches were performed to identify concurrent disorders that can cause insulin resistance. The dog was found to have concurrent hyperadrenocorticism, hyperlipidemia, pancreatitis, and vaginal cytology indicating diestrus in the estrus cycle. Trilostane administration for hyperadrenocorticism improved the insulin response; however, the dog remained hyperglycemic. Eventually, the dog showed complete remission without insulin administration 1 week after the ovariohysterectomy. The dog remained in remission for approximately 4 months, but eventually relapsed and the condition was permanent. Diestrus in intact females and hyperadrenocorticism are known to be the two main causes of insulin resistance in dogs. After the management of these conditions, the dog achieved diabetes remission, which rarely achieves in dogs. In cases of insulin resistance, such as hormonal imbalances or inflammatory conditions, remission can be achieved by addressing the underlying cause. Hence, it is important to assess the presence of comorbidities associated with insulin resistance in dogs with poorly controlled diabetes mellitus and to treat each condition as soon as possible.

Purpose: The purpose of this study was to analyze factors influencing diabetic retinal examination in community-dwelling older adults with diabetes, in order to provide basic data to improve screening rates of diabetic retinal examination. Methods: This study used raw data from the National Community Health Survey, 2020, which is a cross-sectional survey. The subjects of this study are 16,031 old adults aged over 65 years who had been diagnosed with diabetes. The demographic characteristics, diabetes and diseaserelated characteristics, social distancing and fear of COVID-19 according to the diabetic retinal examination were analyzed with chi-square test. Logistic regression analyses were used to examine the factors influencing diabetic retinal examination. Results: We identified that diabetic retinal examination was associated with age, residence, level of education, income, type of diabetes care, period of diabetes, and fear of COVID-19. Conclusion: Health care workers in the community should strongly recommend yearly diabetic retinal examination for diabetic patients who older adults, have lower levels of education and income. A multiple approach is required to raise the low screening rate of diabetic retinal examination, including lower the cost burden.

This study aimed to provide directions and implications for a future program by analyzing studies on diabetes programs from 2000 to 2020. Among the studies with control and experimental groups, the selected studies included ones that provided intervention to patients with diabetes and ones that contained descriptive statistics. Sixteen studies were selected to verify the effectiveness and homogeneity of the data coding meta-analysis. The overall effect size in the diabetes program combined estimate was 0.398 (95% CI: 0.268, 0.425, p=0.000). Among the dependent variables, fasting blood glucose (－0.616) and glycated hemoglobin (－0.442) showed median effect sizes, but the effect of fasting blood glucose was not statistically significant. In terms of the study design, non-randomized control trials (NRCTs) (－0.543) was more effective than randomized control trials (RCTs) (0.719). Among, the counseling and self-management program (－3.241) showed a very large effect size. Furthermore, the cognitive-behavioral (－0.828) and self-management (－0.482) programs were also found to have a positive effect on lowering fasting blood glucose. As the importance of diabetes management increases, further studies based on RCT should be actively performed, and differentiated and specialized diabetes intervention plans need to be established.

Declined salivary gland function is commonly observed in patients with diabetes. Advanced glycation end products (AGEs) are believed to contribute to the pathogenesis of diabetes-induces hypofunction of the salivary glands. Polydatin (resveratrol-3-O-β-mono-D-glucoside) is a polyphenol that can be easily accessed from peanut, grape, and red wines. Although polydatin is known to have anti-glycation, anti-oxidation, and anti-inflammation effects, its effect in the salivary gland is not known. In the present study, we evaluated the AGEs burden in the salivary gland in streptozotocin (STZ)-induced diabetic rats and the protective effect of polydatin on diabetes-related salivary hypofunction. Polydatin (50 and 100 mg/kg/day) was orally administered in the STZ-induced diabetic rats for 4 weeks. The results showed that the salivary flow rate of the STZ-induced diabetic rats was reduced compared with that in the normoglycemic control rats. The circulating AGEs in serum and secreted AGEs in saliva increased in the STZ-induced diabetic rats. The reactive oxygen specises (ROS) were highly generated in the salivary gland in these diabetic rats. The salivary gland from the diabetic rats showed increased acinar cell apoptosis compared to normoglycemic control mice. However, polydatin suppressed all of these diabetes-related salivary changes. Overall, polydatin could provide a beneficial option for diabetes-related salivary hypofunction.

본 연구의 목적은 고혈압 및 당뇨병을 진단 받은 성인의 뇌졸중 및 심근경색증의 조기 증상 인지 정도를 파악하고 비인지와 관련된 요인을 분석하기 위함이다. 2017년 지역사회건강조사 원시자료를 활용하여, 40세 이상 성인 12,277명의 자료를 분석하였다. 뇌졸중 및 심근경색증의 조기 증상 인지율은 각각 53.6%와 46.8%였다. 뇌졸중 및 심근경색증 조기 증상 비인지 요인을 평가하기 위해 로지스틱 분석을 수행 하였다. 고혈압 관리 교육, 혈압 수치 및 당화혈색소 수치 인식은 다변량 분석에서 인구사회학적 변수를 보정한 후에도 뇌졸중 조기 증상 비인지와 유의한 관련이 있었다. 혈압 수치 및 당화혈색소 수치 인식은 심근 경색증 조기 증상 비인지와 유의한 관련이 있었다. 그러므로 고혈압과 당뇨병을 모두 관리해야 하는 고위험군에 대한 홍보 촉진 및 교육 강화 등 심뇌혈관질환 조기 증상 인지 수준 개선을 위한 중재 및 전략의 개발이 요구된다.

A one-year-old, intact male Maltese was referred with dehydration, anorexia, and marked hyperglycemia. The dog had been managed due to meningoencephalitis of unknown etiology (MUE) for three months. The dog had been treated with long-term prednisolone administration. Diabetic ketoacidosis (DKA) was identified based on the blood chemistry and venous gas analyses, and intensive treatments including insulin administration were initiated. On further examinations, there was no any other disease that contributed to the occurrence of DKA. Insulin resistance resulted from the administration of prednisolone was highly suspected, but the agent could not be tapered due to managing MUE. Following resolution of DKA, the dog was discharged with life-long insulin and prednisolone therapy. Over the next two years, the dog continued to be routinely re-evaluated and was managed with permanent insulin therapy (0.8–1.4 units/kg SC 12 hourly) and medications including prednisolone (0.4–1.1 mg/kg PO 12 hourly). Because MUE severely progressed, the dog was euthanized by owner’s request. Histopathologic examination of pancreas obtained by post-mortem revealed that both endo- and exocrine pancreas was within normal limit. The case described herein showed the risk of ketoacidosis as well as hyperglycemia after long-term prednisolone administration in a dog without pancreatic islet pathology.

본 연구는 스트렙토조토신에 의해 유도한 당뇨병, 알코올성 간 손상 실험용 랫드에서 혈액 지질 감소, 당뇨병 및 알코올성 간 손상 예방에 미치는 지장김치 추출물의 경구투여 효과를 조사하였다. 당뇨병 모델동물에서, 혈액 지질 프로파일, ALT, AST 수준은 DC (당뇨병 대조군)와 비교할 때 김치추출물 투여군에서 낮아졌으며 혈당은 DCJK (DC+지장김치 추출물 경구투여군)가 DCCK (DC+일반김치 추출물 경구투여군)에 비해 낮았다. 인슐린 수준은 NC (정상대조군), DCJK > DCCK > DC 순서로 높게 나타났다. 알코올성 간 손상 모델동물에서, 혈액 ALT, AST, 빌리루빈 농도는 AC (알코올 대조군, 일일 소주 1병 섭취군) > ACCK (AC+일반김치 추출물 경구투여군) > ACJK (AC+지장김치 추출물 경 구투여군) > NC 순서로 낮았다. 간 조직의 임상병리학적 소견은 AC에서 가장 심각한 손상을 보였으나 소주1병과 김치 추출물 특히, 지장김치 추출물 경구투여군은 일반김치 추출물 경구투여군에 비해서 회복되는 속도가 개선되었다. 결과는 당뇨병 및 알코올성 간 손상 모델동물에서 지장김치의 섭취가 혈액 지질 프로파일, 혈당, ALT, AST 수준을 낮추고 인슐린 분비능력을 개선하여 줌으로써 항당뇨 및 알코올성 간 손상 보호효과를 갖는다는 사실을 보여준다.

The objective of this study was to investigate the effects of dietary vitamin B intake on biomarkers related to lipid metabolism, inflammation and blood glucose control, that are important in the development of type 2 diabetes and its complications. Seventy-six adults (42 males, 34 females) were recruited from a group of diabetes patients who had visited the medical center for treatment. Data on anthropometric characteristics and dietary intake of thiamine, riboflavin, niacin, vitamin B6 and folate were collected using 24-hour diet recall and the CAN Pro 4.0 program. Also, data on clinical indices such as serum lipids, blood pressure, high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c) and homeostasis model assessment 2-insulin resistance (HOMA2-IR) were collected and analyzed for correlation with dietary vitamin B intake. Results from the dietary intake survey showed that riboflavin and folate intake (in males) and folate intake (in females) were below the Dietary Reference Intake for Koreans. Statistical analysis revealed a negative correlation between hs-CRP and dietary intake of B vitamins. Riboflavin intake was inversely associated with systolic blood pressure after adjustments for age, BMI, smoking, alcohol consumption, exercise, ingestion of diabetes mellitus medication and energy intake (p<0.05). Our results suggest that dietary vitamin B may influence inflammation and consequently may help in better management of type 2 diabetes.

This study aimed to investigate the effect of ladder-climbing exercise training on neurobiological markers in the hippocampus of mice with type 2 diabetes (T2DM). Twenty-one C57BL/6 male mice were randomly assigned to the non-diabetic control (NDC, n = 7), diabetic control (DC, n = 7), and diabetic training (DT, n = 7) groups. The DT group performed ladder-climbing training (LCT) five times a week for eight weeks. We measured the levels of hippocampal neurobiological markers (catalase [CAT], brain-derived neurotrophic factor [BDNF], nerve growth factor [NGF], amyloid-beta [Aβ], tau, and CC motif chemokine ligand 11 [CCL11]). The BDNF levels were significantly higher in the DT group than in the DC group (p < 0.05). The Aβ and CCL11 levels were significantly higher in the DC group than in the NDC and DT groups (p < 0.05). The tau levels were significantly higher in the DC group than in the NDC group (p < 0.05). However, there was no significant difference in CAT and NGF levels among the groups (p > 0.05). These results suggest that while T2DM could induce neurodegeneration, LCT may be effective in alleviating neurodegeneration caused by T2DM.

본 연구는 만 65세 이상 85세 이하의 제2형 당뇨병 비만 여성 노인을 대상으로 12주간 복합운동 후 irisin, 신체조성 및 당 대사에 미치는 영향을 구명하기 위하여 복합운동군(n=20), 대조군(n=16)으로 구분하여 실시하였다. 복합운동 프로그램은 야외 걷기 운동과 탄성 밴드 운동을 12주간 주 3회, 1회 60분 간 실시하였으며, 야외 걷기 운동의 운동강도는 중강도(RPE 5~6)로 수행되었으며, 탄성 밴드 운동은 1~4주는 저강도(OMNI-RES 3~4), 5~8주는 중강도(OMNI-RES 5~6), 9~12주는 고강도(OMNI-RES 7~8)로 점진적으로 운동강도를 증가시켰다. 그 결과 복합운동군의 irisin이 유의하게 증가하였고(p<.001), 체지방률은 유의하게 감소하였으며(p<.001), 골격근량은 유의하게 증가하였다(p<.001). 당 대사 관련 인자 중 HbA1c(p=.020), 혈당(p<.001)은 유의하게 감소하였고, HOMA-β는 유의하게 증가하였다(p<.001). Irisin의 변화는 체지방률의 변화와 부적 상관이 있는 것으로 나타났고(r=-.423, p=.010), 유산소성 지구력 변화와 정적 상관이 있었다(r=.355, p=.034). 또한, HbA1c(r=-.351, p=.036)와 혈당(r=-.424, p=.010)의 변화는 부적 상관이 있었으며, HOMA-β는 정적 상관이 있는 것으로 나타났다(r=.411, p=.013). 결론적 으로 규칙적인 복합운동의 실천은 제2형 당뇨병 비만 여성노인의 혈중 irisin의 수준을 증가하고, 신체조성 변화에 긍정적인 영향을 주는 것으로 나타났다. 그리고 당화혈색소, 공복혈당 및 인슐린 분비능을 개선하여 당 대사 조절 능력에 도움을 주어 당뇨 예방 및 관리를 위해 효과적인 운동으로 권장될 것으로 사료된다.

This study includes the clinical features of diabetic patients with fascial space infections of head and neck and those of non-diabetic patients. We retrospectively studied 62 patients who were treated for fascial space infections of the head and neck, and compared the patients’ background, the aetiology of the infection, clinical variables, laboratory values, and treatment process. Statistical analyses of the differences between groups were made with Student's t test, the chi square test, and analysis of variance, as appropriate. Diabetic patients had more spaces involved, had longer hospital stays, and developed more complications. The main microorganism of diabetic group was Klebsiella pneumonia and otherwise, Streptococcus spp. was for non-diabetic group. We conclude that diabetic patients are more likely to develop complications and it is necessary to consider about dominant microorganism when using medication for diabetes patients

To determine the effect of the tumor necrosis factor-α (TNF-α) in odontoclast formation, we administrated a TNF-α inhibitor in rats with diabetes rats with periodontitis. The rats included in the study were divided into three groups: control rats without diabetes or periodontitis (the C group), rats with periodontitis and diabetes (the PD group), and rats with periodontitis and diabetes treated by infliximab, the TNF inhibitor (the PD+infliximab group). The PD and PD+ infliximab groups received intravenous administrations of streptozotocin (STZ, 50 mg/kg) to induce diabetes. After 7 days of STZ injections, the mandibular first molars were ligatured to induce periodontitis. The PD+infliximab group was intrapenitoneally administrated by infliximab (5 mg/kg). On days 3 and 20 after the ligature administration, odontoclast formation along root surfaces was evaluated by tartrate resistant acid phosphatase (TRAP) staining and cathepsin K immunohistochemistry. On day 3, the number of TRAP- and cathepsin K-positive cells increased more so in the PD group than in the C group. The PD+infliximab group showed a lower number of positive cells than the PD group. There was no difference in all the groups on day 20. On day 3, the cathepsin-K positive multinucleated and mononucleated cells were higher in the PD group than in the C group. The number of cathepsin-K positive multinucleated cells was lower in the PD+infliximab group than in the PD group. The PD group showed more cathepsin K-positive cells in the furcation and distal surfaces than the c group. The Cathepsin K-positive cells of the PD+infliximab group were lower than that of the PD group in furcation. These results suggest that TNF-α stimulates odontoclast formation in diabetes with periodontitis.

Superovulation is a technique to acquire rats to produce many eggs than normal rats. Superovulated eggs were used to make cloned animals through somatic cell nuclear transfer technology (SCNT). Healthy and valuable oocyte retrieval is essential for successful somatic cell nuclear transfer. Superovulation is also essential to maximize to the yield of IVF-derived rat eggs. Osmotic pumps (Alzet®) are miniature in order to provide research with a convenient, and reliable alternative to chronic injections. Acquiring superovulated oocytes through osmotic pump in minimizing irritation to the uterus and ovaries are competitive. We investigated the effects of pregnant mare serum gonadotropin (PMSG) and human Chorionic Gonadotropin (hCG) using osmotic pump in sDM rat. Adult female rats at 11 wks of age were used for superovulation. The response to PMSG and hCG were examined by osmotic pump of 150 IU/kg PMSG + 75 IU/kg hCG or 150 IU/kg PMSG + 150 IU/kg hCG or 300 IU/kg PMSG + 150 IU/kg hCG or 300 IU/kg PMSG + 300 IU/kg hCG. HCG was administered 48 hrs later after administration of PMSG. Oocytes were collected from the oviducts 16–18 hrs after hCG administration. Superovulation was significantly higher in rats administrated 150 IU/kg PMSG + 75 IU/kg hCG. This study demonstrated that healthy oocytes were produced in DM rat by PMSG and hCG that flowed through the osmotic pump ameliorate on uterus and ovaries.

Several species show low sensitivity to IVM, and the development of optimized medium possible oocyte quality and stable growth. Furthermore, adding additive to the medium can effectively reducing development cost and leads to easy handling of oocytes. Isoliquritigenin and formononetin are extracts found in licorice. Previous studies reported that isoliquritigenin and formononetin affected the activity of sperm, but the oocytes are unknown. This study adds isoliquritigenin or formononetin to αMEM to mature oocytes under simple IVC conditions. Recovered oocytes are cultured in αMEM, isoliquritigenincontaining medium and formononetin-containing medium. In study we proved that in addition to the medium, above the quality of oocytes cultured when specific additives were added, more stable growth is possible. collection and IVM of oocyte. SD rats at 6 to 8 wks of age are injected is intraperitoneal with 30 IU/mL of PMSG and 48 hrs later, HCG 50 IU/mL is intraperitoneal injected. Oocytes are collected ovary after 17 hrs. Collected oocytes are cultured for 16 hrs with 200 μL αMEM and 200 μL αMEM containing isoliquritigenin or formononetin at 0, 0.01, 0.02, 0.04, 0.1 mg/mL. Also, isoliquritigenin and formononetin were mixed with 200 μL αMEM at a ratio of 0.25: 0.75, 0.50: 0.50, and 0.75: 0.25 mg/mL respectively. Oocytes supplemented with isoliquritigenin and Formononetin had high quality than oocytes cultured with αMEM and showed an increase in the IVF fertility rate. Our experimental results indicate that using isoliquritigenin, formononetin when cell culture, rather than used only in medium, more effective oocyte quality and stable growth.

This study was conducted to determine the association between dietary calcium intake and biomarkers related to lipid and glucose metabolism and inflammation in Korean patients with type 2 diabetes. Seventy-five subjects (41 males, 34 females) were recruited from a group of patients who had visited the department of endocrine medicine. Data on anthropometric characteristics, clinical indices such as hemoglobin A1c and C-reactive protein (CRP), and dietary nutrient intakes were collected. Subjects were divided into three groups on the basis of their calcium intake [<EAR (below estimated average requirement), EAR-RNI (between EAR and recommended nutrient intake), >RNI (above RNI)]. Average calcium intake of <EAR, EAR-RNI, >RNI groups were 462.7±18.7, 649.7±12.8, and 895.7±21.7 mg, respectively. Energy intake was not different among groups but intakes of protein, total and saturated fatty acids were significantly higher in >RNI group than <EAR group. Analysis of covariance revealed that HDL cholesterol level was significantly higher in EAR-RNI group, as compared to <EAR group after adjustment with confounders such as age, sex, BMI and energy intake (p<0.05). Levels of CRP and homeostasis model assessment 2-insulin resistance (HOMA2-IR) were significantly lower in EAR-RNI group. Total cholesterol level was higher in EAR-RNI and >RNI groups, although within the normal range. Our results suggest that dietary calcium intake may influence the levels of HDL-cholesterol, CRP and HOMA2-IR and subsequently, help management/treatment of type 2 diabetes patients.

This study was designed to investigate dietary life related to sodium of participants in hypertension and diabetes preventive education at the public health center located in Incheon Metropolitan City. Subjects were comprised of 301 adults (males: 102, female: 199) of age 50 years and above. The questionnaire for dietary life and salty taste assessment were performed on the subjects. Data were analyzed using SPSS package (ver. 18.0). According to the result of questionnaire for dietary behavior, 70% of the subjects were in the low salt intake group (p<0.001). In the result of questionnaire for dietary frequency, all ages groups were in the low salt intake group (p<0.01). The data of questionnaire for dietary behavior showed that the subjects of age above 75 years preferred salted seafood, soup, and kimchi (p<0.01). The data of questionnaire for dietary frequency showed that the subjects of age between 65 and 74, least chose fried kimchi, noodle, and soybean paste soup with clams (p<0.05), and the healthy adult groups chose kimchi stew, ssam and ssamjang (p<0.05). The score for dietary behavior in male subjects was higher than female subjects (p<0.01). In particular, the score for dietary frequency was the lowest in the subjects of age between 65 and 74 (p<0.01). The mean value of salty taste assessment in the subjects was 0.41% which is higher than the ideal value of 0.3% (p<0.01). Offering more nutrition education and continuous feedback of healthcare center may be needed to improve the health status of the adults.