Endocrinology and Metabolism

Hong-Kyu Kim

4 Articles

Mineral, Bone & Muscle
Carnitine Metabolite as a Potential Circulating Biomarker for Sarcopenia in Men: Je Hyun Seo, Jung-Min Koh, Han Jin Cho, Hanjun Kim, Young‑Sun Lee, Su Jung Kim, Pil Whan Yoon, Won Kim, Sung Jin Bae, Hong-Kyu Kim, Hyun Ju Yoo, Seung Hun Lee; Endocrinol Metab. 2025;40(1):93-102. Published online November 28, 2024; DOI: https://doi.org/10.3803/EnM.2024.2117

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Abstract PDF Supplementary Material PubReader ePub: Background
Sarcopenia, a multifactorial disorder involving metabolic disturbance, suggests potential for metabolite biomarkers. Carnitine (CN), essential for skeletal muscle energy metabolism, may be a candidate biomarker. We investigated whether CN metabolites are biomarkers for sarcopenia.
Methods
Associations between the CN metabolites identified from an animal model of sarcopenia and muscle cells and sarcopenia status were evaluated in men from an age-matched discovery (72 cases, 72 controls) and a validation (21 cases, 47 controls) cohort.
Results
An association between CN metabolites and sarcopenia showed in mouse and cell studies. In the discovery cohort, plasma C5-CN levels were lower in sarcopenic men (P=0.005). C5-CN levels in men tended to be associated with handgrip strength (HGS) (P=0.098) and were significantly associated with skeletal muscle mass (P=0.003). Each standard deviation increase in C5-CN levels reduced the odds of low muscle mass (odd ratio, 0.61; 95% confidence interval [CI], 0.42 to 0.89). The area under the receiver operating characteristic curve (AUROC) of CN score using a regression equation of C5-CN levels, for sarcopenia was 0.635 (95% CI, 0.544 to 0.726). In the discovery cohort, addition of CN score to HGS significantly improved AUROC from 0.646 (95% CI, 0.575 to 0.717; HGS only) to 0.727 (95% CI, 0.643 to 0.810; P=0.006; HGS+CN score). The improvement was confirmed in the validation cohort (AUROC=0.563; 95% CI, 0.470 to 0.656 for HGS; and AUROC=0.712; 95% CI, 0.569 to 0.855 for HGS+CN score; P=0.027).
Conclusion
C5-CN, indicative of low muscle mass, is a potential circulating biomarker for sarcopenia in men. Further studies are required to confirm these results and explore sarcopenia-related metabolomic changes.

Miscellaneous
Quality Matters as Much as Quantity of Skeletal Muscle: Clinical Implications of Myosteatosis in Cardiometabolic Health: Hong-Kyu Kim, Chul-Hee Kim; Endocrinol Metab. 2021;36(6):1161-1174. Published online December 28, 2021; DOI: https://doi.org/10.3803/EnM.2021.1348

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Although age-related changes in skeletal muscles are closely associated with decreases in muscle strength and functional decline, their associations with cardiometabolic diseases in the literature are inconsistent. Such inconsistency could be explained by the fact that muscle quality—which is closely associated with fatty infiltration of the muscle (i.e., myosteatosis)—is as important as muscle quantity in cardiometabolic health. However, muscle quality has been less explored compared with muscle mass. Moreover, the standard definition of myosteatosis and its assessment methods have not been established yet. Recently, some techniques using single axial computed tomography (CT) images have been introduced and utilized in many studies, as the mass and quality of abdominal muscles could be measured opportunistically on abdominal CT scans obtained during routine clinical care. Yet, the mechanisms by which myosteatosis affect metabolic and cardiovascular health remain largely unknown. In this review, we explore the recent advances in the assessment of myosteatosis and its changes associated with aging. We also review the recent literature on the clinical implication of myosteatosis by focusing on metabolic and cardiovascular diseases. Finally, we discuss the challenges and unanswered questions that need addressing to set myosteatosis as a therapeutic target for the prevention or treatment of cardiometabolic diseases.

Citations

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Inhibition of serotonin-Htr2b signaling in skeletal muscle mitigates obesity-induced insulin resistance
Suhyeon Park, Hyeongseok Kim, Soyeon Shin, Yeongmin Kim, Yunwon Kang, Hye-Na Cha, So-Young Park, Sangkyu Park, Chang-Myung Oh
Experimental & Molecular Medicine.2025;[Epub] CrossRef
The Role of Muscle Density in Predicting the Amputation Risk in Peripheral Arterial Disease: A Tissue Composition Study Using Lower Extremity CT Angiography
Yueh-Hung Lin, Pei-Shan Tsai, Chung-Lieh Hung, Mirza Faisal Beg, Hung-I Yeh, Chun-Ho Yun, Ming-Ting Wu
Diagnostics.2025; 15(11): 1439. CrossRef
A CT-based Deep Learning Model for Predicting Subsequent Fracture Risk in Patients with Hip Fracture
Yisak Kim, Young-Gon Kim, Jung-Wee Park, Byung Woo Kim, Youmin Shin, Sung Hye Kong, Jung Hee Kim, Young-Kyun Lee, Sang Wan Kim, Chan Soo Shin
Radiology.2024;[Epub] CrossRef
Myosteatosis is associated with poor survival after kidney transplantation: a large retrospective cohort validation
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Abdominal Radiology.2024; 49(4): 1210. CrossRef
Fatty infiltration of gastrocnemius–soleus muscle complex: Considerations for myosteatosis rehabilitation
Catherine Hatzantonis, Lalith Satkunam, Karyne N. Rabey, Jennifer C. Hocking, Anne M. R. Agur
Journal of Anatomy.2024; 245(1): 50. CrossRef
Muscle attenuation, not skeletal muscle index, is an independent prognostic factor for survival in gastric cancer patients with overweight and obesity
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Myosteatosis is associated with coronary artery calcification in patients with type 2 diabetes
Fu-Peng Liu, Mu-Jie Guo, Qing Yang, Yan-Ying Li, Yan-Gang Wang, Mei Zhang
World Journal of Diabetes.2024; 15(3): 429. CrossRef
Unlocking liver health: Can tackling myosteatosis spark remission in metabolic dysfunction‐associated steatotic liver disease?
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Liver International.2024; 44(8): 1781. CrossRef
Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women
Thaís Loureiro Felipe, Patrícia Paula da Fonseca Grili, Camila Vilarinho Vidigal, Ben-Hur Albergaria, Geise Ferreira da Cruz, José Luiz Marques-Rocha, Valdete Regina Guandalini
Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics.2024;[Epub] CrossRef
Skeletal Muscle Injury in Chronic Kidney Disease—From Histologic Changes to Molecular Mechanisms and to Novel Therapies
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A Computed Tomography–Based Fracture Prediction Model With Images of Vertebral Bones and Muscles by Employing Deep Learning: Development and Validation Study
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Journal of Medical Internet Research.2024; 26: e48535. CrossRef
Association between atherogenic dyslipidemia and muscle quality defined by myosteatosis
Hwi Seung Kim, Yun Kyung Cho, Myung Jin Kim, Eun Hee Kim, Min Jung Lee, Woo Je Lee, Hong-Kyu Kim, Chang Hee Jung
Frontiers in Endocrinology.2024;[Epub] CrossRef
The Correlation Between Visceral Fat Area to Skeletal Muscle Mass Ratio and Multiorgan Insulin Resistance in Chinese Population With Obesity
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Comparative analysis of body composition using torso CT from PET/CT with bioelectrical impedance and muscle strength in healthy adults
Dong Yun Lee, Jungsu S. Oh, Jeong Won Kim, Jae Seung Kim, Minyoung Oh, Yong-il Kim, Duk Han Ko, Sung-Jin Bae, Hong-Kyu Kim, Jin-Sook Ryu
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Association of serum gamma-glutamyl transferase with myosteatosis assessed by muscle quality mapping using abdominal computed tomography
Han Na Jung, Yun Kyung Cho, Hwi Seung Kim, Eun Hee Kim, Min Jung Lee, Joong-Yeol Park, Woo Je Lee, Hong-Kyu Kim, Chang Hee Jung
Clinical Imaging.2023; 93: 4. CrossRef
Increased visceral fat area to skeletal muscle mass ratio is positively associated with the risk of cardiometabolic diseases in a Chinese natural population: A cross‐sectional study
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Association between hypertension and myosteatosis evaluated by abdominal computed tomography
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Association between sarcopenic obesity and poor muscle quality based on muscle quality map and abdominal computed tomography
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Increase in skeletal muscular adiposity and cognitive decline in a biracial cohort of older men and women
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Evaluation of Paraspinal Muscle Degeneration on Pain Relief after Percutaneous Epidural Adhesiolysis in Patients with Degenerative Lumbar Spinal Disease
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Association Between Insulin Resistance and Myosteatosis Measured by Abdominal Computed Tomography
Myung Jin Kim, Yun Kyung Cho, Han Na Jung, Eun Hee Kim, Min Jung Lee, Chang Hee Jung, Joong-Yeol Park, Hong-Kyu Kim, Woo Je Lee
The Journal of Clinical Endocrinology & Metabolism.2023; 108(12): 3100. CrossRef
Association of Visceral Fat Obesity, Sarcopenia, and Myosteatosis with Non-Alcoholic Fatty Liver Disease without Obesity
Hong-Kyu Kim, Sung-Jin Bae, Min Jung Lee, Eun Hee Kim, Hana Park, Hwi Seung Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee, Jaewon Choe
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Muscle Fat Content Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis in Chinese Adults
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Assessment of Muscle Quantity, Quality and Function
Bo Kyung Koo
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Influence of cross‐sectional area and fat infiltration of paraspinal muscles on analgesic efficacy of epidural steroid injection in elderly patients
Hee Jung Kim, Miribi Rho, Kyung Bong Yoon, Minju Jo, Dong Woo Lee, Shin Hyung Kim
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Marika Murawiak, Roma Krzymińska-Siemaszko, Aleksandra Kaluźniak-Szymanowska, Marta Lewandowicz, Sławomir Tobis, Katarzyna Wieczorowska-Tobis, Ewa Deskur-Śmielecka
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Metabolic mechanisms for and treatment of NAFLD or NASH occurring after liver transplantation
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Diabetes, Obesity and Metabolism
Prognostic Value of Triglyceride and Glucose Index for Incident Type 2 Diabetes beyond Metabolic Health and Obesity: Hwi Seung Kim, Jiwoo Lee, Yun Kyung Cho, Eun Hee Kim, Min Jung Lee, Hong-Kyu Kim, Joong-Yeol Park, Woo Je Lee, Chang Hee Jung; Endocrinol Metab. 2021;36(5):1042-1054. Published online October 21, 2021; DOI: https://doi.org/10.3803/EnM.2021.1184

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Background
Metabolically healthy obese (MHO) phenotype is metabolically heterogeneous in terms of type 2 diabetes (T2D). Previously, the triglyceride and glucose (TyG) index has been considered for identifying metabolic health and future risk of T2D. This study aimed to evaluate the risk of incident T2D according to obesity status and metabolic health, categorized by four different criteria and the TyG index.
Methods
The study included 39,418 Koreans without T2D at baseline. The risk of T2D was evaluated based on four different definitions of metabolic health and obesity status and according to the baseline TyG index within each metabolic health and obesity group.
Results
During the median follow-up at 38.1 months, 726 individuals developed T2D. Compared with the metabolically healthy non-obese (MHNO) group with low TyG index, the MHO group with high TyG index showed increased risk of T2D in all four definitions of metabolic health with multivariate-adjusted hazard ratios of 2.57 (95% confidence interval [CI], 1.76 to 3.75), 3.72 (95% CI, 2.15 to 6.43), 4.13 (95% CI, 2.67 to 6.38), and 3.05 (95% CI, 2.24 to 4.15), when defined by Adult Treatment Panel III, Wildman, Karelis, and homeostasis model assessment (HOMA) criteria, respectively.
Conclusion
MHO subjects with high TyG index were at an increased risk of developing T2D compared with MHNO subjects, regardless of the definition of metabolic health. TyG index may serve as an additional factor for predicting the individual risk of incident T2D in MHO subjects.

Citations

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Bridging the gap in obesity research: A consensus statement from the European Society for Clinical Investigation
Federico Carbone, Jean‐Pierre Després, John P. A. Ioannidis, Ian J. Neeland, Gabriella Garruti, Luca Busetto, Luca Liberale, Stefano Ministrini, Gemma Vilahur, Thomas H. Schindler, Maria Paula Macedo, Agostino Di Ciaula, Marcin Krawczyk, Andreas Geier, Gy
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Clinical Study
Gender-Dependent Reference Range of Serum Calcitonin Levels in Healthy Korean Adults: Eyun Song, Min Ji Jeon, Hye Jin Yoo, Sung Jin Bae, Tae Yong Kim, Won Bae Kim, Young Kee Shong, Hong-Kyu Kim, Won Gu Kim; Endocrinol Metab. 2021;36(2):365-373. Published online April 7, 2021; DOI: https://doi.org/10.3803/EnM.2020.939

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Background
Serum calcitonin measurement contains various clinical and methodological aspects. Its reference level is wide and unclear despite sensitive calcitonin kits are available. This study aimed to identify the specific reference range in the healthy Korean adults.
Methods
Subjects were ≥20 years with available calcitonin (measured by a two-site immunoradiometric assay) data by a routine health checkup. Three groups were defined as all eligible subjects (group 1, n=10,566); subjects without self or family history of thyroid disease (group 2, n=5,152); and subjects without chronic kidney disease, autoimmune thyroid disease, medication of proton pump inhibitor/H2 blocker/steroid, or other malignancies (group 3, n=4,638).
Results
This study included 6,341 male and 4,225 female subjects. Males had higher mean calcitonin than females (2.3 pg/mL vs. 1.9 pg/mL, P<0.001) in group 1. This gender difference remained similar in groups 2 and 3. Calcitonin according to age or body mass index was not significant in both genders. Higher calcitonin in smoking than nonsmoking men was observed but not in women. Sixty-nine subjects had calcitonin higher than the upper reference limit (10 pg/mL) and 64 of them had factors associated with hypercalcitoninemia besides medullary thyroid cancer. Our study suggests the reference intervals for men who were non, ex-, current smokers, and women (irrespective of smoking status) as <5.7, <7.1, <7.9, and <3.6 pg/mL, respectively.
Conclusion
Specific calcitonin reference range should be provided considering for sex and smoking status. Taking account for several factors known to induce hypercalcitoninemia can help interpret the gray zone of moderately elevated calcitonin.

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