Endocrinology and Metabolism

Editorial

Thyroid
The Levothyroxine Odyssey: Navigating the Path of Survivorship in Thyroid Cancer: Jin Hwa Kim; Endocrinol Metab. 2024;39(2):283-284. Published online April 25, 2024; DOI: https://doi.org/10.3803/EnM.2024.201

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Special Articles

Miscellaneous
Immune Checkpoint Inhibitors and Endocrine Disorders: A Position Statement from the Korean Endocrine Society: Hyemi Kwon, Eun Roh, Chang Ho Ahn, Hee Kyung Kim, Cheol Ryong Ku, Kyong Yeun Jung, Ju Hee Lee, Eun Heui Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Jun Sung Moon, Jin Hwa Kim, Mi-kyung Kim, The Committee of Clinical Practice Guideline of the Korean Endocrine Society; Endocrinol Metab. 2022;37(6):839-850. Published online December 26, 2022; DOI: https://doi.org/10.3803/EnM.2022.1627

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Immune checkpoint inhibitors (ICIs) including an anti-cytotoxic T-lymphocyte-associated antigen 4 inhibitor, anti-programmed cell death protein 1 (PD-1) inhibitors, and anti-PD-ligand 1 inhibitors are representative therapeutics for various malignancies. In oncology, the application of ICIs is currently expanding to a wider range of malignancies due to their remarkable clinical outcomes. ICIs target immune checkpoints which suppress the activity of T-cells that are specific for tumor antigens, thereby allowing tumor cells to escape the immune response. However, immune checkpoints also play a crucial role in preventing autoimmune reactions. Therefore, ICIs targeting immune checkpoints can trigger various immune-related adverse events (irAEs), especially in endocrine organs. Considering the endocrine organs that are frequently involved, irAEs associated endocrinopathies are frequently life-threatening and have unfavorable clinical implications for patients. However, there are very limited data from large clinical trials that would inform the development of clinical guidelines for patients with irAEs associated endocrinopathies. Considering the current clinical situation, in which the scope and scale of the application of ICIs are increasing, position statements from clinical specialists play an essential role in providing the appropriate recommendations based on both medical evidence and clinical experience. As endocrinologists, we would like to present precautions and recommendations for the management of immune-related endocrine disorders, especially those involving the adrenal, thyroid, and pituitary glands caused by ICIs.

Citations

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Pembrolizumab plus lenvatinib for radically unresectable or metastatic renal cell carcinoma in the Japanese population
Ryo Fujiwara, Takeshi yuasa, kenichi kobayashi, tetsuya yoshida, susumu kageyama
Expert Review of Anticancer Therapy.2023; 23(5): 461. CrossRef
Incidence of Endocrine-Related Dysfunction in Patients Treated with New Immune Checkpoint Inhibitors: A Meta-Analysis and Comprehensive Review
Won Sang Yoo, Eu Jeong Ku, Eun Kyung Lee, Hwa Young Ahn
Endocrinology and Metabolism.2023; 38(6): 750. CrossRef

Miscellaneous
COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society: Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim, the Committee of Clinical Practice Guideline of the Korean Endocrine Society; Endocrinol Metab. 2021;36(4):757-765. Published online August 17, 2021; DOI: https://doi.org/10.3803/EnM.2021.404

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Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

Citations

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COVID-19 mRNA vaccine may trigger subacute thyroiditis
Mehmet Sözen, Ömercan Topaloğlu, Berrin Çetinarslan, Alev Selek, Zeynep Cantürk, Emre Gezer, Damla Köksalan, Taner Bayraktaroğlu
Human Vaccines & Immunotherapeutics.2024; 17(12): 5120. CrossRef
The role of co-morbidities in the development of an AEFI after COVID-19 vaccination in a large prospective cohort with patient-reported outcomes in the Netherlands
C. Ouaddouh, J.W. Duijster, T. Lieber, F.P.A.M. van Hunsel
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Thyroid dysfunction in COVID-19
David Tak Wai Lui, Chi Ho Lee, Yu Cho Woo, Ivan Fan Ngai Hung, Karen Siu Ling Lam
Nature Reviews Endocrinology.2024;[Epub] CrossRef
Adult-Onset Type 1 Diabetes Development Following COVID-19 mRNA Vaccination
Hyeyeon Moon, Sunghwan Suh, Mi Kyoung Park
Journal of Korean Medical Science.2023;[Epub] CrossRef
Prior immunization status of COVID-19 patients and disease severity: A multicenter retrospective cohort study assessing the different types of immunity
Javaria Aslam, Faisal Shahzad Khan, Muhammad Talha Haris, Hewad Hewadmal, Maryam Khalid, Mohammad Y. Alshahrani, Qurrat-ul-ain Aslam, Irrum Aneela, Urooj Zafar
Vaccine.2023; 41(2): 598. CrossRef
Mortality and Severity of Coronavirus Disease 2019 in Patients with Long-Term Glucocorticoid Therapy: A Korean Nationwide Cohort Study
Eu Jeong Ku, Keeho Song, Kyoung Min Kim, Gi Hyeon Seo, Soon Jib Yoo
Endocrinology and Metabolism.2023; 38(2): 253. CrossRef
Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study
Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo
Journal of Clinical Medicine.2023; 12(14): 4799. CrossRef
Inactivated SARS-CoV-2 vaccination does not disturb the clinical course of Graves’ disease: An observational cohort study
Shichen Xu, Huixin Yu, Xian Cheng, Jing Wu, Jiandong Bao, Li Zhang
Vaccine.2023; 41(38): 5648. CrossRef
Adrenal Crisis Associated With COVID-19 Vaccination in Patients With Adrenal Insufficiency
Yukako Kurematsu, Takako Mohri, Sadanori Okada, Yutaka Takahashi
JCEM Case Reports.2023;[Epub] CrossRef
Adverse Events Associated with COVID-19 Vaccination in Adolescents with Endocrinological Disorders: A Cross-Sectional Study
İbrahim Mert Erbaş, İrem Ceren Erbaş, Gözde Akın Kağızmanlı, Kübra Yüksek Acinikli, Özge Besci, Korcan Demir, Ece Böber, Nurşen Belet, Ayhan Abacı
Journal of Clinical Research in Pediatric Endocrinology.2023; 15(3): 248. CrossRef
Neue Aspekte der Glukokortikoidsubstitution bei Nebennierenrindeninsuffizienz
Tina Kienitz, Gesine Meyer
Der Internist.2022; 63(1): 12. CrossRef
Endocrine Follow-up During Post-Acute COVID-19: Practical Recommendations Based on Available Clinical Evidence
Rimesh Pal, Ameya Joshi, Sanjay K. Bhadada, Mainak Banerjee, Suresh Vaikkakara, Satinath Mukhopadhyay
Endocrine Practice.2022; 28(4): 425. CrossRef
Safety of Inactivated and mRNA COVID-19 Vaccination Among Patients Treated for Hypothyroidism: A Population-Based Cohort Study
Xi Xiong, Carlos King Ho Wong, Ivan Chi Ho Au, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Celine Sze Ling Chui, Esther Wai Yin Chan, Franco Wing Tak Cheng, Kristy Tsz Kwan Lau, Chi Ho Lee, Yu Cho Woo, David Tak Wai Lui, Ian Chi Kei Wong
Thyroid.2022; 32(5): 505. CrossRef
The New Entity of Subacute Thyroiditis amid the COVID-19 Pandemic: From Infection to Vaccine
Mihaela Popescu, Adina Ghemigian, Corina Maria Vasile, Andrei Costache, Mara Carsote, Alice Elena Ghenea
Diagnostics.2022; 12(4): 960. CrossRef
Adrenal Crisis Secondary to COVID-19 Vaccination in a Patient With Hypopituitarism
Nikolina Markovic, Anila Faizan, Chirag Boradia, Sridhar Nambi
AACE Clinical Case Reports.2022; 8(4): 171. CrossRef
The Effect of Inactivated SARS-CoV-2 Vaccines on TRAB in Graves’ Disease
LingHong Huang, ZhengRong Jiang, JingXiong Zhou, YuPing Chen, HuiBin Huang
Frontiers in Endocrinology.2022;[Epub] CrossRef
Osteoporosis in Patients With Respiratory Diseases
Yue Ma, Shui Qiu, Renyi Zhou
Frontiers in Physiology.2022;[Epub] CrossRef
Pilot Findings on SARS-CoV-2 Vaccine-Induced Pituitary Diseases: A Mini Review from Diagnosis to Pathophysiology
Ach Taieb, El Euch Mounira
Vaccines.2022; 10(12): 2004. CrossRef
Forty Years Together, New Leap Forward! The 40th Anniversary of the Korean Endocrine Society
Jong Chul Won, Ki-Hyun Baek
Endocrinology and Metabolism.2022; 37(6): 851. CrossRef
No need of glucocorticoid dose adjustment in patients with adrenal insufficiency before COVID-19 vaccine
Tania Pilli, Cristina Dalmiglio, Gilda Dalmazio, Alfonso Sagnella, Raffaella Forleo, Lucia Brilli, Fabio Maino, Cristina Ciuoli, Maria Grazia Castagna
European Journal of Endocrinology.2022; 187(1): K7. CrossRef
Diabetes and COVID-19 Vaccination
Hae Dong Choi, Jun Sung Moon
The Journal of Korean Diabetes.2021; 22(4): 221. CrossRef

Hypothalamus and Pituitary gland
Medical Treatment with Somatostatin Analogues in Acromegaly: Position Statement: Sang Ouk Chin, Cheol Ryong Ku, Byung Joon Kim, Sung-Woon Kim, Kyeong Hye Park, Kee Ho Song, Seungjoon Oh, Hyun Koo Yoon, Eun Jig Lee, Jung Min Lee, Jung Soo Lim, Jung Hee Kim, Kwang Joon Kim, Heung Yong Jin, Dae Jung Kim, Kyung Ae Lee, Seong-Su Moon, Dong Jun Lim, Dong Yeob Shin, Se Hwa Kim, Min Jeong Kwon, Ha Young Kim, Jin Hwa Kim, Dong Sun Kim, Chong Hwa Kim; Endocrinol Metab. 2019;34(1):53-62. Published online March 21, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.1.53

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The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.

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Hydrogel-fiber-mesh-based 3D cell cultures: A new method for studying pituitary tumors
Wooju Jeong, Sungrok Wang, Yumin Kim, Soohyun Lee, Minhu Huang, Jaeil Park, Myung-Han Yoon, Chang-Myung Oh, Cheol Ryong Ku
Smart Materials in Medicine.2024;[Epub] CrossRef
Evaluation and Management of Bone Health in Patients with Thyroid Diseases: A Position Statement of the Korean Thyroid Association
A Ram Hong, Ho-Cheol Kang
Endocrinology and Metabolism.2023; 38(2): 175. CrossRef
Growth Hormone Excess: Implications and Management
Suneela Dhaneshwar, Shrishti Shandily, Vatsalya Tiwari
Endocrine, Metabolic & Immune Disorders - Drug Targets.2023; 23(6): 748. CrossRef
Revisiting the usefulness of the short acute octreotide test to predict treatment outcomes in acromegaly
Montserrat Marques-Pamies, Joan Gil, Elena Valassi, Marta Hernández, Betina Biagetti, Olga Giménez-Palop, Silvia Martínez, Cristina Carrato, Laura Pons, Rocío Villar-Taibo, Marta Araujo-Castro, Concepción Blanco, Inmaculada Simón, Andreu Simó-Servat, Gemm
Frontiers in Endocrinology.2023;[Epub] CrossRef
Evaluation and Management of Bone Health in Patients with Thyroid Diseases: a Position Statement from the Korean Thyroid Association
A Ram Hong, Hwa Young Ahn, Bu Kyung Kim, Seong Hee Ahn, So Young Park, Min-Hee Kim, Jeongmin Lee, Sun Wook Cho, Ho-Cheol Kang
International Journal of Thyroidology.2022; 15(1): 1. CrossRef
Octreotide in the treatment of acromegaly – the possibilities of high-dose therapy
I. A. Ilovayskaya
Meditsinskiy sovet = Medical Council.2022; (10): 148. CrossRef
Approach of Acromegaly during Pregnancy
Alexandru Dan Popescu, Mara Carsote, Ana Valea, Andreea Gabriela Nicola, Ionela Teodora Dascălu, Tiberiu Tircă, Jaqueline Abdul-Razzak, Mihaela Jana Țuculină
Diagnostics.2022; 12(11): 2669. CrossRef
Left to themselves: Time to target chronic pain in childhood rare diseases
Christine B. Sieberg, Alyssa Lebel, Erin Silliman, Scott Holmes, David Borsook, Igor Elman
Neuroscience & Biobehavioral Reviews.2021; 126: 276. CrossRef
Severe respiratory failure in a patient with COVID-19 and acromegaly: rapid improvement after adding octreotide
Jacob Luty, LesleAnn Hayward, Melanie Jackson, P Barton Duell
BMJ Case Reports.2021; 14(8): e243900. CrossRef
Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?
Cheol Ryong Ku, Vladimir Melnikov, Zhaoyun Zhang, Eun Jig Lee
Endocrinology and Metabolism.2020; 35(2): 206. CrossRef
Medical Treatment with Somatostatin Analogues in Acromegaly: Position Statement
Sang Ouk Chin, Cheol Ryong Ku, Byung Joon Kim, Sung-Woon Kim, Kyeong Hye Park, Kee Ho Song, Seungjoon Oh, Hyun Koo Yoon, Eun Jig Lee, Jung Min Lee, Jung Soo Lim, Jung Hee Kim, Kwang Joon Kim, Heung Yong Jin, Dae Jung Kim, Kyung Ae Lee, Seong-Su Moon, Dong
The Korean Journal of Medicine.2019; 94(6): 485. CrossRef

Original Article

Clinical Study
Urinary Albumin Excretion Reflects Cardiovascular Risk in Postmenopausal Women without Diabetes: The 2011 to 2013 Korean National Health and Nutrition Examination Survey: Hee Jung Ahn, Do Sik Moon, Da Yeong Kang, Jung In Lee, Da Young Kim, Jin Hwa Kim, Sang Yong Kim, Hak Yeon Bae; Endocrinol Metab. 2016;31(4):537-546. Published online November 3, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.537

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Background

The objective of the current study was to determine whether there was an association between urinary albumin excretion and cardiovascular disease (CVD) risk by estimating the Framingham Risk Score (FRS) in postmenopausal women without diabetes.

Methods

This study was based on data from the Korea National Health and Nutrition Examination Survey, which was conducted by the Korean Ministry of Health and Welfare in 2011 to 2013. Data on 2,316 postmenopausal women from a total of 24,594 participants was included in the analysis.

Results

The mean FRS was significantly different in each of the urinary albumin to creatinine ratio (UACR) subgroups, and it increased with UACR. The FRS was 12.69±0.12 in the optimal group, 14.30±0.19 in the intermediate normal group, 14.62±0.26 in the high normal group, and 15.86±0.36 in the microalbuminuria group. After fully adjusting for potential confounding factors, high normal levels and microalbuminuria were significantly associated with the highest tertile of FRS ([odds ratio (OR), 1.642; 95% confidence interval (CI), 1.124 to 2.400] and [OR, 3.385; 95% CI, 2.088 to 5.488], respectively) compared with the optimal subgroup. High normal levels and microalbuminuria were also significantly associated with a ≥10% 10-year risk of CVD ([OR, 1.853; 95% CI, 1.122 to 3.060] and [OR, 2.831; 95% CI, 1.327 to 6.037], respectively) after adjusting for potential confounding covariates.

Conclusion

Urinary albumin excretion reflects CVD risk in postmenopausal women without diabetes, and high normal levels and microalbuminuria were independently associated with a higher risk of CVD.

Citations

Citations to this article as recorded by

Association between urinary albumin creatinine ratio and cardiovascular disease
Yoo Jin Kim, Sang Won Hwang, Taesic Lee, Jun Young Lee, Young Uh, Gulali Aktas
PLOS ONE.2023; 18(3): e0283083. CrossRef
Relationship between Hypertension and the Declining Renal Function in Korean Adults
Jun Ho Lee
The Korean Journal of Clinical Laboratory Science.2021; 53(1): 32. CrossRef
Significance of Obstetrical History with Future Cardiovascular Disease Risk
Emmanuel Bassily, Cameron Bell, Sean Verma, Nidhi Patel, Aarti Patel
The American Journal of Medicine.2019; 132(5): 567. CrossRef
Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef

Letter

Obesity and Metabolism
Letter: Serum Concentrations of Ghrelin and Leptin according to Thyroid Hormone Condition, and Their Correlations with Insulin Resistance (Endocrinol Metab 2015;30:318-25, Kyu-Jin Kim et al.): Jin Hwa Kim; Endocrinol Metab. 2015;30(4):631-632. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.631

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Original Articles

Thyroid
The Validity of Ultrasonography-Guided Fine Needle Aspiration Biopsy in Thyroid Nodules 4 cm or Larger Depends on Ultrasonography Characteristics: Jin Hwa Kim, Na Kyung Kim, Young Lyun Oh, Hye Jeong Kim, Sang Yong Kim, Jae Hoon Chung, Sun Wook Kim; Endocrinol Metab. 2014;29(4):545-552. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.545

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Background

The objective of this study was to evaluate the validity of fine needle aspiration biopsy (FNAB) according to ultrasonography (US) characteristics in thyroid nodules 4 cm and larger.

Methods

We retrospectively reviewed the cases of 263 patients who underwent thyroid surgery for thyroid nodules larger than 4 cm between January 2001 and December 2010.

Results

The sensitivity of US-FNAB was significantly higher in nodules with calcifications (micro- or macro-) than those without (97.9% vs. 87.% P<0.05). The accuracy of US-FNAB was higher in large thyroid nodules with US features suspicious of malignancy, such as a solid component, ill-defined margin, hypoechogenicity or marked hypoechogenicity, or any calcifications (micro- or macro-) compared to thyroid nodules with none of these features. Furthermore, the accuracy improved as the number of these features increased. The overall false negative rate (FNR) was 11.9%. The FNR of thyroid nodules that appeared benign on US, such as mixed nodules (7.7%) or nodules without calcification (9.8%), trended toward being lower than that of solid nodules (17.9%) or nodules with any microcalcification or macrocalcification (33.3%). In nodules without suspicious features of malignancy, the FNR of US-FNAB was 0% (0/15).

Conclusion

We suggest individualized strategies for large thyroid nodules according to US features. Patients with benign FNAB can be followed in the absence of any malignant features in US. However, if patients exhibit any suspicious features, potential false negative results of FNAB should be kept in mind and surgery may be considered.

Citations

Citations to this article as recorded by

Risk of malignancy and diagnostic accuracy of fine-needle aspiration biopsy in thyroid nodules with diameters greater than 4 centimeters
Rafaela N. Barcelos, Cléber P. Camacho, Maria da Conceição de O. C. Mamone, Elza S. Ikejiri, Felipe A. B. Vanderlei, Ji H. Yang, Rosália P. Padovani, Leandro A. L. Martins, Rosa Paula M. Biscolla, Danielle Macellaro, Susan C. Lindsey, Rui M. B. Maciel, Jo
Archives of Endocrinology and Metabolism.2023;[Epub] CrossRef
The comparison of accuracy of ultrasonographic features versus ultrasound-guided fine-needle aspiration cytology in diagnosis of malignant thyroid nodules
Mehrdad Nabahati, Zoleika Moazezi, Soude Fartookzadeh, Rahele Mehraeen, Naser Ghaemian, Majid Sharbatdaran
Journal of Ultrasound.2019; 22(3): 315. CrossRef
False negative rate of fine‐needle aspiration in thyroid nodules: impact of nodule size and ultrasound pattern
Hye Shin Ahn, Dong Gyu Na, Jung Hwan Baek, Jin Yong Sung, Ji‐Hoon Kim
Head & Neck.2019; 41(4): 967. CrossRef
Thyroid nodules over 4 cm do not have higher malignancy or benign cytology false-negative rates
Muhammed Kizilgul, Rupendra Shrestha, Angela Radulescu, Maria R. Evasovich, Lynn A. Burmeister
Endocrine.2019; 66(2): 249. CrossRef
Large Cytologically Benign Thyroid Nodules Do Not Have High Rates of Malignancy or False-Negative Rates and Clinical Observation Should be Considered: A Meta-Analysis
Nicole A. Cipriani, Michael G. White, Peter Angelos, Raymon H. Grogan
Thyroid.2018; 28(12): 1595. CrossRef
Risk of Malignancy in Thyroid Nodules 4 cm or Larger
Uchechukwu C. Megwalu
Endocrinology and Metabolism.2017; 32(1): 77. CrossRef
Usefulness of NRAS codon 61 mutation analysis and core needle biopsy for the diagnosis of thyroid nodules previously diagnosed as atypia of undetermined significance
Eun Kyung Jang, Won Gu Kim, Eui Young Kim, Hyemi Kwon, Yun Mi Choi, Min Ji Jeon, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Jene Choi, Dong Eun Song, Won Bae Kim
Endocrine.2016; 52(2): 305. CrossRef
Association between neck ultrasonographic findings and clinico‐pathological features in the follicular variant of papillary thyroid carcinoma
Eun Kyung Jang, Won Gu Kim, Yun Mi Choi, Min Ji Jeon, Hyemi Kwon, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Dong Eun Song, Won Bae Kim
Clinical Endocrinology.2015; 83(6): 968. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef

Obesity and Metabolism
Hemoglobin A1c Is Positively Correlated with Framingham Risk Score in Older, Apparently Healthy Nondiabetic Korean Adults: Ji Hye Shin, Ji In Kang, Yun Jung, Young Min Choi, Hyun Jung Park, Jung Hae So, Jin Hwa Kim, Sang Yong Kim, Hak Yeon Bae; Endocrinol Metab. 2013;28(2):103-109. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.103

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Background

Several studies have suggested that elevated levels of hemoglobin A1c (HbA1c) are associated with cardiovascular disease (CVD) in nondiabetic individuals. However, it is unclear whether HbA1c levels can serve as a simple screening marker for increased CVD risk in nondiabetic individuals. Our objective was to evaluate the relationship between HbA1c levels and CVD risk using the Framingham risk score (FRS) in older, apparently healthy nondiabetic Korean adults.

Methods

We retrospectively studied 2,879 Korean adults between the ages of 40 and 79 who underwent voluntary health check-ups at the Health Promotion Center of our hospital from July 2009 to June 2011. Subjects were subdivided based on their HbA1c levels into four groups: tertiles within the HbA1c normal tolerance range and a group for subjects with an increased risk for diabetes (IRD).

Results

The mean FRS for the upper tertile (9.6±3.8) group was significantly higher than that of the middle tertile (8.4±4.0) and lower tertile (7.6±3.8) groups. In addition, FRS was highest in the IRD group (10.5±3.7). Multiple linear regression analysis demonstrated that HbA1c levels exhibited a significant positive correlation with FRS when adjusted for confounding variables in all subjects (β±standard error [SE], 0.018±0.002; R², 0.131), women (β±SE, 0.023±0.003; R², 0.170), and men (β±SE, 0.016±0.004; R², 0.109).

Conclusion

HbA1c levels were positively correlated with FRS in older, apparently healthy nondiabetic Korean adults. We propose that HbA1c levels may reflect CVD risk in nondiabetic individuals.

Citations

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Correlation between cardiovascular risk and glycemic control among patients with diabetes
Naomi Niari Dalimunthe, Herwindo Ahmad, Dina Arwina Dalimunthe
MGM Journal of Medical Sciences.2024; 11(1): 44. CrossRef
Framingham Risk Score Assessment in Subjects with Pre-diabetes and Diabetes: A Cross-Sectional Study in Korea
Hyuk Sang Kwon, Kee Ho Song, Jae Myung Yu, Dong Sun Kim, Ho Sang Shon, Kyu Jeung Ahn, Sung Hee Choi, Seung Hyun Ko, Won Kim, Kyoung Hwa Lee, Il Seong Nam-Goong, Tae Sun Park
Journal of Obesity & Metabolic Syndrome.2021; 30(3): 261. CrossRef
Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
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Randomized, Open-Label, Parallel Group Study to Evaluate the Effect of Internet-Based Glucose Management System on Subjects with Diabetes in China
Hun-Sung Kim, Chenglin Sun, So Jung Yang, Lin Sun, Fei Li, In Young Choi, Jae-Hyoung Cho, Guixia Wang, Kun-Ho Yoon
Telemedicine and e-Health.2016; 22(8): 666. CrossRef
GA to HbA1C ratio, but not HbA1C is associated with cognition in Chinese nondiabetic old adults
Yuan Zhong, Jun Jin, Chan Chan Xu, Guo Xiang Fu
Aging & Mental Health.2015; 19(9): 853. CrossRef
Relationship of Glycated Hemoglobin A1c, Coronary Artery Calcification and Insulin Resistance in Males Without Diabetes
Chan-Hee Jung, Eun-Jung Rhee, Kyu-Jin Kim, Bo-Yeon Kim, Se Eun Park, Yoosoo Chang, Seungho Ryu, Cheol-Young Park, Ji-Oh Mok, Ki-Won Oh, Chul-Hee Kim, Sung-Woo Park, Sung-Koo Kang, Won-Young Lee
Archives of Medical Research.2015; 46(1): 71. CrossRef
Evaluation of Nutrient Intake and Food Variety in Korean Male Adults according to Framingham Risk Score
Mi-Kyeong Choi, Yun-Jung Bae
The Korean Journal of Food And Nutrition.2014; 27(3): 484. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef
Suicidal ideation and suicide attempts among diabetes mellitus: The Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007 to 2012
Jae Ho Chung, Kitae Moon, Do Hyung Kim, Joo-Won Min, Tae Ho Kim, Hee-Jin Hwang
Journal of Psychosomatic Research.2014; 77(6): 457. CrossRef

Case Reports

Diabetic Ketoacidosis Associated with Emphysematous Gastritis: A Case Report.: Young Min Choi, Jun Won Seo, Woo Jin Lee, Hyeong Jin Park, Ji Hye Shin, Seung Bum Kang, Jun Lee, Jin Hwa Kim, Sang Yong Kim, Hak Yeon Bae; Endocrinol Metab. 2011;26(4):355-359. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.355

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Abstract PDF: Diabetic ketoacidosis is a serious and demanding medical emergency for the field of endocrinology, and the identification and correction of the precipitating factors is equally important. Many patients of diabetic ketoacidosis show gastrointestinal symptoms as an initial presentation, and coincidental gastrointestinal diseases can be neglected or misdiagnosed. Emphysematous gastritis is a rare and lethal disease in which gas bubbles form in the stomach wall. The predisposing factors include ingestion of corrosive substances, alcohol abuse, diabetes, and immunosuppressive therapy. Thus, it may be difficult to detect emphysematous gastritis early, especially when it is developed in conjunction with diabetic ketoacidosis. We report a case of diabetic ketoacidosis associated with emphysematous gastritis in a young male without medical history.

Graves' Disease Accompanied by Pheochromocytoma: Report of a Case.: Jin Hwa Kim, Sang Jun Lee, Ji Hye Shin, Mi Ra You, Jae Sik Jung, Sang Yong Kim, Hak Yeon Bae; J Korean Endocr Soc. 2009;24(2):126-131. Published online June 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.2.126

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We present here a rare case of Graves' disease accompanied by pheochromocytoma, and the patient showed normal urine and serum levels of catecholamines and their metabolites. A 45-year-old woman was referred to our hospital for the evaluation of a right adrenal incidentaloma that was detected by chest computed tomography. She had been diagnosed with Graves' disease 1 month previously. She had no symptoms of pheochromocytoma such as hypertension or a history of hypertension attack. Two consecutive 24-hour urine samples were sent to the lab for measurement of the catecholamines, and both samples showed normal levels of metanephrine and vanillylmandelic acid (VMA). After right adrenalectomy was performed, the final pathological diagnosis was adrenal pheochromocytoma. This case suggests that the onset of Graves' disease may be associated with excess catecholamine secreted by a pheochromocytoma. In addition, although the conventional method for detecting pheochromocytoma is to identify an increase of the urine catecholamines, physicians should be aware of the possibility of false negativity on this test.

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Functional retroperitoneal paraganglioma invading the inferior vena cava in the elderly, a case report and literature review
Mohamed Aymane Loukili, Imane Assarrar, Nada El Yamani, Anass Haloui, Siham Rouf, Hanane Latrech
International Journal of Surgery Case Reports.2023; 109: 108547. CrossRef

A Case of Adult Onset Type II Citrullinemia with SLC25A13 Gene Mutation.: Jin Hwa Kim, Keo Woon Park, Chul Jin Park, Gil Hong Sun, Hyung Ho Kim, Sang Yong Kim, Hak Yoen Bae, Eun Hae Cho, Song Hyun Yang; J Korean Endocr Soc. 2006;21(6):542-547. Published online December 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.6.542

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Abstract PDF: Adult onset type II citrullinemia is an autosomal recessive disorder of the amino acid metabolism caused by a deficiency of liver specific argininosuccinate synthetase activity. This disease can occur at any age in life with recurrent episodes of neurological signs and symptoms such as disorientation, abnormal behaviors (aggression, irritability and hyperactivity), seizures, coma and potential death from brain edema, which are resulted from hyperammonemia. We should consider this rare metabolic disease for the adult patient who exhibits mental change and hyperammonemia without liver or brain disease. Recently. SLC25A13 gene, encoding the mitochondrial aspartate glutamate carrier protein named citrin, is demonstrated to be responsible for adult onset type II citrullinemia. We experienced a 39-year-old female who suffered from generalized weakness, dizziness and lethargy, and diagnosed as adult onset type II citrullinemia by highly elevated plasma citrulline and ammonia and the SLC25A13 gene mutation. We report here on this unusual case of adult onset type II citrullulinemia with a brief review of the related literature.

A Case of Hashimoto's Thyroiditis Associated with Multiple Sclerosis.: Beom Ju Lee, Jong Chan Oh, Sang Yong Kim, Dong Hyun Choi, Jung In Kim, Gyung Nam Kim, Jin Hwa Kim, Hak Yeon Bae; J Korean Endocr Soc. 2004;19(4):426-432. Published online August 1, 2004

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Abstract PDF: Multiple sclerosis is an autoimmune disorder, which may be associated with other rheumatologic or endocrine diseases induced by autoantibodies. Hashimoto's thyroiditis is also an organ-specific autoimmune disorder, and its association with multiple sclerosis during interferon therapy has been reported. Cases of Hashimoto's thyroiditis with multiple sclerosis are very rare. Herein is reported our experience of a 27 year-old woman who presented with general weakness, cold intolerance and progressive muscle weakness. She had been treated with levothyroxine due to subclinical hypothyroidism, which rather aggravated the symptom. In a CSF analysis, the myelin basic protein level was above 10 ng/dL and that of the IgG and the IgG index were 135 mg/dL and 7.8, respectively. In a brain MRI, demyelinating lesions in the left middle pontocerebellar junction and right subcortex were shown. She was diagnosed with multiple sclerosis, and the symptom improved after glucocorticoid and levothyroxine therapy. Herein is reported the first Korean case of Hashimoto's thyroiditis associated with multiple sclerosis

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