- Diabetes, obesity and metabolism
- Greater Severity of Steatosis Is Associated with a Higher Risk of Incident Diabetes: A Retrospective Longitudinal Study
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Ji Min Han, Jung Hwan Cho, Hye In Kim, Sunghwan Suh, Yu-Ji Lee, Jung Won Lee, Kwang Min Kim, Ji Cheol Bae
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Endocrinol Metab. 2023;38(4):418-425. Published online July 12, 2023
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DOI: https://doi.org/10.3803/EnM.2023.1729
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Abstract
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- Background
Fatty liver is associated with increased risk of developing type 2 diabetes. We aimed to evaluate whether the severity of hepatic steatosis is associated with incident diabetes.
Methods We conducted a longitudinal analysis using data from 1,798 participants who underwent a comprehensive health checkup and abdominal computed tomography (CT). We assessed the association between baseline liver attenuation value on non-contrast CT images and risk of incident diabetes. All the participants were categorized into three groups based on the baseline liver attenuation value on non-contrast CT images: without hepatic steatosis (>57 Hounsfield unit [HU]), mild hepatic steatosis (41–57 HU), and moderate to severe hepatic steatosis (≤40 HU).
Results During a median follow-up period of 5 years, 6.0% of the study participants progressed to diabetes. The incidence of diabetes was 17.3% in the moderate to severe hepatic steatosis group, 9.0% in the mild steatosis group, and 2.9% in those without hepatic steatosis. In a multivariate adjustment model, as compared with participants without hepatic steatosis, those with moderate to severe steatosis had a hazard ratio (HR) of 3.24 (95% confidence interval [CI], 1.64 to 4.2) for the development of diabetes, and those in the mild steatosis group had a HR of 2.33 (95% CI, 1.42 to 3.80). One standard deviation decrease in mean CT attenuation values of the liver was associated with a 40% increase in the development of diabetes (multivariate adjusted HR, 1.40; 95% CI, 1.2 to 1.63).
Conclusion We found a positive association between severity of hepatic steatosis and risk of incident diabetes. Greater severity of steatosis was associated with a higher risk of incident diabetes.
- Diabetes, Obesity and Metabolism
- DPP-4 Inhibitor in Type 2 Diabetes Mellitus Patient with Non-Alcoholic Fatty Liver Disease: Achieving Two Goals at Once?
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Ji Cheol Bae
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Endocrinol Metab. 2022;37(6):858-860. Published online December 26, 2022
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DOI: https://doi.org/10.3803/EnM.2022.605
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1,366
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- Physiology, pharmacology and prospects for dipeptidilpeptidase-4 inhibitors use
D. V. Kurkin, D. A. Bakulin, E. I. Morkovin, A. V. Strygin, Yu. V. Gorbunova, E. V. Volotova, I. E. Makarenko, V. B. Saparova, R. V. Drai, V. I. Petrov Pharmacy & Pharmacology.2023; 11(1): 19. CrossRef - Comparative effects between old and new antidiabetic agents on metabolic- associated fatty liver disease (MAFLD)
André J. Scheen Diabetes Epidemiology and Management.2023; 11: 100145. CrossRef - Pharmacokinetic, toxicological, and clinical considerations for the treatment of type 2 diabetes in patients with liver disease: a comprehensive update
André J. Scheen Expert Opinion on Drug Metabolism & Toxicology.2023; 19(8): 543. CrossRef
- Diabetes, Obesity and Metabolism
- The Impact of Insulin Resistance on Hepatic Fibrosis among United States Adults with Non-Alcoholic Fatty Liver Disease: NHANES 2017 to 2018
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Ji Cheol Bae, Lauren A. Beste, Kristina M. Utzschneider
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Endocrinol Metab. 2022;37(3):455-465. Published online June 21, 2022
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DOI: https://doi.org/10.3803/EnM.2022.1434
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3,425
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- Background
We aimed to investigate the association of hepatic steatosis with liver fibrosis and to assess the interactive effects of hepatic steatosis and insulin resistance on liver fibrosis in a nationally representative sample of United States adults.
Methods We conducted a cross-sectional analysis using data from National Health and Nutrition Examination Survey 2017 to 2018, which for the first time included transient elastography to assess liver stiffness and hepatic steatosis. We evaluated the association between hepatic steatosis (using controlled attenuation parameter [CAP]) and clinically significant liver fibrosis (defined as liver stiffness ≥7.5 kPa) using logistic regression with an interaction term for hepatic steatosis and insulin resistance (defined as homeostatic model assessment of insulin resistance ≥3.0).
Results Among adults undergoing transient elastography (n=2,023), 45.9% had moderate or greater hepatic steatosis and 11.3% had clinically significant liver fibrosis. After adjustment for demographic and metabolic factors, the odds of significant liver fibrosis increased as CAP score rose (odds ratio, 1.35 per standard deviation increment; 95% confidence interval, 1.11 to 1.64). We detected a significant interaction effect between CAP score and insulin resistance on the probability of significant liver fibrosis (P=0.016 for interaction). The probability of significant liver fibrosis increased in the presence of insulin resistance with increasing CAP score, while those without insulin resistance had low probability of significant liver fibrosis, even with high CAP scores.
Conclusion Individuals with hepatic steatosis had higher odds of fibrosis when insulin resistance was present. Our findings emphasize the importance of the metabolic aspects of the disease on fibrosis risk and suggest a need to better identify patients with metabolic associated fatty liver disease.
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Citations
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- Greater Severity of Steatosis Is Associated with a Higher Risk of Incident Diabetes: A Retrospective Longitudinal Study
Ji Min Han, Jung Hwan Cho, Hye In Kim, Sunghwan Suh, Yu-Ji Lee, Jung Won Lee, Kwang Min Kim, Ji Cheol Bae Endocrinology and Metabolism.2023; 38(4): 418. CrossRef - Hepatic T-cell senescence and exhaustion are implicated in the progression of fatty liver disease in patients with type 2 diabetes and mouse model with nonalcoholic steatohepatitis
Byeong Chang Sim, Yea Eun Kang, Sun Kyoung You, Seong Eun Lee, Ha Thi Nga, Ho Yeop Lee, Thi Linh Nguyen, Ji Sun Moon, Jingwen Tian, Hyo Ju Jang, Jeong Eun Lee, Hyon-Seung Yi Cell Death & Disease.2023;[Epub] CrossRef - Familial clustering of nonalcoholic fatty liver disease in first‐degree relatives of adults with lean nonalcoholic fatty liver disease
Sorachat Niltwat, Chanin Limwongse, Natthinee Charatcharoenwitthaya, Duangkamon Bunditvorapoom, Wimolrak Bandidniyamanon, Phunchai Charatcharoenwitthaya Liver International.2023;[Epub] CrossRef - Metabolic Score for Insulin Resistance Is Inversely Related to Incident Advanced Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
Jun-Hyuk Lee, Yu-Jin Kwon, Kyongmin Park, Hye Sun Lee, Hoon-Ki Park, Jee Hye Han, Sang Bong Ahn Nutrients.2022; 14(15): 3039. CrossRef - DPP-4 Inhibitor in Type 2 Diabetes Mellitus Patient with Non-Alcoholic Fatty Liver Disease: Achieving Two Goals at Once?
Ji Cheol Bae Endocrinology and Metabolism.2022; 37(6): 858. CrossRef
- Clinical Study
- Association of Body Mass Index with the Risk of Incident Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality: A Community-Based Prospective Study
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Ji Cheol Bae, Nam H. Cho, Jae Hyeon Kim, Kyu Yeon Hur, Sang-Man Jin, Moon-Kyu Lee
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Endocrinol Metab. 2020;35(2):416-424. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.416
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7,470
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- Background
Type 2 diabetes and cardiovascular disease (CVD) are the most important sequelae of obesity and the leading cause of death. We evaluated the association between body mass index (BMI) and the risk of incident type 2 diabetes, CVD, and all-cause mortality in a prospective study of a Korean population.
Methods The shapes of the associations were modeled by restricted cubic splines regression analysis. After categorizing all subjects (n=8,900) into octiles based on their BMI levels, we estimated the hazard ratio (HR) for the association of categorized BMI levels with the risk of incident CVD and type 2 diabetes using a Cox’s proportional hazard analysis.
Results The mean age of participants was 52 years and 48% were men. Of the subjects at baseline, 39.0% of men and 45.6% of women were classified as obese (BMI ≥25 kg/m2). Over a mean follow-up of 8.1 years, CVD events occurred in 509 participants; 436 died; and 1,258 subjects developed type 2 diabetes. The increased risk of incident diabetes began to be significant at BMI 23 to 24 kg/m2 in both sexes (HR, 1.8). For CVD events, the risk began to increase significantly at BMI 26 to 28 kg/m2 (HR, 1.6). We found a reverse J-shaped relationship between BMI and all-cause mortality, with an increased risk among individuals with BMI values in lower range (BMI <21 kg/m2).
Conclusion These results suggest that the BMI cut-off points for observed risk were varied depending on the diseases and that the BMI classification of obesity need to be revised to reflect differential risk of obesity-related diseases.
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- Metabolic status indicators and influencing factors in non-obese, non-centrally obese nonalcoholic fatty liver disease
Zhipeng Huang, Donghong Wei, Xueping Yu, Zicheng Huang, Yijie Lin, Wenji Lin, Zhijun Su, Jianjia Jiang Medicine.2023; 102(6): e32922. CrossRef - Establishment and health management application of a prediction model for high-risk complication combination of type 2 diabetes mellitus based on data mining
Xin Luo, Jijia Sun, Hong Pan, Dian Zhou, Ping Huang, Jingjing Tang, Rong Shi, Hong Ye, Ying Zhao, An Zhang, Yee Gary Ang PLOS ONE.2023; 18(8): e0289749. CrossRef - Body mass index at baseline directly predicts new-onset diabetes and to a lesser extent incident cardio-cerebrovascular events, but has a J-shaped relationship to all-cause mortality
Yoon-Jong Bae, Sang-Jun Shin, Hee-Taik Kang BMC Endocrine Disorders.2022;[Epub] CrossRef - Association of Shift Work with Normal-Weight Obesity in Community-Dwelling Adults
Chul Woo Ahn, Sungjae Shin, Seunghyun Lee, Hye-Sun Park, Namki Hong, Yumie Rhee Endocrinology and Metabolism.2022; 37(5): 781. CrossRef - The Prognostic Value of Combined Status of Body Mass Index and Psychological Well-Being for the Estimation of All-Cause and CVD Mortality Risk: Results from a Long-Term Cohort Study in Lithuania
Dalia Lukšienė, Abdonas Tamosiunas, Ricardas Radisauskas, Martin Bobak Medicina.2022; 58(11): 1591. CrossRef - The Relationship between Body Mass Index and Incident Diabetes Mellitus in Chinese Aged Population: A Cohort Study
M. L. Tang, Y. Q. Zhou, A. Q. Song, J. L. Wang, Y. P. Wan, R. Y. Xu, Carol Forsblom Journal of Diabetes Research.2021; 2021: 1. CrossRef - Correlation between adiponectin level and the degree of fibrosis in patients with non-alcoholic fatty liver disease
Manal Sabry Mohamed, Tarek Mohammed Youssef, Esraa Ebrahim Abdullah, Ahmed Elmetwally Ahmed Egyptian Liver Journal.2021;[Epub] CrossRef - Obesity Measures as Predictors of Type 2 Diabetes and Cardiovascular Diseases among the Jordanian Population: A Cross-Sectional Study
Hana Alkhalidy, Aliaa Orabi, Khadeejah Alnaser, Islam Al-Shami, Tamara Alzboun, Mohammad D. Obeidat, Dongmin Liu International Journal of Environmental Research and Public Health.2021; 18(22): 12187. CrossRef
- Thyroid
- Clinical Outcomes of Differentiated Thyroid Cancer Patients with Local Recurrence or Distant Metastasis Detected in Old Age
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Ji Min Han, Ji Cheol Bae, Hye In Kim, Sam Kwon, Min Ji Jeon, Won Gu Kim, Tae Yong Kim, Young Kee Shong, Won Bae Kim
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Endocrinol Metab. 2018;33(4):459-465. Published online November 30, 2018
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DOI: https://doi.org/10.3803/EnM.2018.33.4.459
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4,244
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- Background
Differentiated thyroid carcinoma (DTC) shows a very good prognosis, but older patients have a higher recurrence rate and those show poor prognosis than younger patients. The aim of this study was to determine the clinical outcomes of thyroid cancer patients who experienced recurrence in old age according to the treatment strategy used. MethodsThis retrospective observational cohort study was conducted at Asan Medical Center, Seoul, Korea. Among DTC patients with no evidence of disease after initial treatment, we enrolled 86 patients who experienced recurrence at an age >65 years from 1994 to 2012. Sixty-nine patients had local recurrence and 17 patients showed distant metastasis. ResultsThe mean age of patients at recurrence was 72 years. Patients were followed up for a median of 4.1 years after recurrence. Sixty-three of the 69 patients with local recurrence received additional treatment, while the other six received conservative care. The cancer-specific mortality rate was 15.5% in the local recurrence group. Airway problems were the main cause of death in patients who did not receive further treatment for local recurrence. Among the 17 patients with distant metastasis, 10 underwent specific treatment for metastasis and seven received only supportive management. Seven of those 17 patients died, and the cancer-specific mortality rate was 35% in the distant metastasis group. ConclusionThe overall cancer-specific mortality rate was 20% in DTC patients in whom recurrence was first detected at an age >65 years. Mortality due to uncontrolled local disease occurred frequently in patients who did not receive definitive management for recurrence.
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- Identification of Circulating Tumor Cell Phenotype in Differentiated Thyroid Carcinoma
Huiling Wang, Mian Lv, Yonghong Huang, Xiaoming Pan, Changyuan Wei Journal of Biomaterials and Tissue Engineering.2022; 12(4): 813. CrossRef - Long-Term Outcomes and Prognoses of Elderly Patients (≥65-Years-Old) With Distant Metastases From Well-Differentiated Thyroid Cancer During Radioiodine Therapy and Follow-Up
Zhong-Ling Qiu, Chen-Tian Shen, Zhen-Kui Sun, Hong-Jun Song, Chuang Xi, Guo-Qiang Zhang, Yang Wang, Quan-Yong Luo Frontiers in Endocrinology.2021;[Epub] CrossRef - Head-to-Head Comparison of Neck 18F-FDG PET/MR and PET/CT in the Diagnosis of Differentiated Thyroid Carcinoma Patients after Comprehensive Treatment
Yangmeihui Song, Fang Liu, Weiwei Ruan, Fan Hu, Muhsin H. Younis, Zairong Gao, Jie Ming, Tao Huang, Weibo Cai, Xiaoli Lan Cancers.2021; 13(14): 3436. CrossRef - Highly sensitive electrochemical immunosensor using a protein-polyvinylidene fluoride nanocomposite for human thyroglobulin
Maria Oneide Silva de Moraes, João de Deus Pereira de Moraes Segundo, Marcos Marques da Silva Paula, Maria Goreti Ferreira Sales, Walter Ricardo Brito Bioelectrochemistry.2021; 142: 107888. CrossRef
- Obesity and Metabolism
- Klinefelter Syndrome and Metabolic Disorder
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Ji Cheol Bae
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Endocrinol Metab. 2016;31(4):535-536. Published online December 20, 2016
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DOI: https://doi.org/10.3803/EnM.2016.31.4.535
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2,616
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- Epicardial fat: the role of testosterone and lipid metabolism in a cohort of patients with Klinefelter syndrome
S. Granato, G. Barbaro, M.R. Di Giorgio, F.M. Rossi, C. Marzano, F. Impronta, M. Spaziani, A. Anzuini, A. Lenzi, A.F. Radicioni Metabolism.2019; 95: 21. CrossRef
- Obesity and Metabolism
- Diabetes Drugs and Cardiovascular Safety
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Ji Cheol Bae
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Endocrinol Metab. 2016;31(2):239-244. Published online June 10, 2016
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DOI: https://doi.org/10.3803/EnM.2016.31.2.239
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3,279
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Diabetes is a well-known risk factor of cardiovascular morbidity and mortality, and the beneficial effect of improved glycemic control on cardiovascular complications has been well established. However, the rosiglitazone experience aroused awareness of potential cardiovascular risk associated with diabetes drugs and prompted the U.S. Food and Drug Administration to issue new guidelines about cardiovascular risk. Through postmarketing cardiovascular safety trials, some drugs demonstrated cardiovascular benefits, while some antidiabetic drugs raised concern about a possible increased cardiovascular risk associated with drug use. With the development of new classes of drugs, treatment options became wider and the complexity of glycemic management in type 2 diabetes has increased. When choosing the appropriate treatment strategy for patients with type 2 diabetes at high cardiovascular risk, not only the glucose-lowering effects, but also overall benefits and risks for cardiovascular disease should be taken into consideration.
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- Dipeptidyl peptidase-4 inhibitor compared with sulfonylurea in combination with metformin: cardiovascular and renal outcomes in a propensity-matched cohort study
Kyoung Jin Kim, Jimi Choi, Juneyoung Lee, Jae Hyun Bae, Jee Hyun An, Hee Young Kim, Hye Jin Yoo, Ji A. Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim Cardiovascular Diabetology.2019;[Epub] CrossRef - Sodium‐glucose cotransporter 2 inhibitors regulate ketone body metabolism via inter‐organ crosstalk
Jin Hee Kim, Minyoung Lee, Soo Hyun Kim, So Ra Kim, Byung‐Wan Lee, Eun Seok Kang, Bong‐Soo Cha, Jin Won Cho, Yong‐ho Lee Diabetes, Obesity and Metabolism.2019; 21(4): 801. CrossRef - Glitazones and alpha-glucosidase inhibitors as the second-line oral anti-diabetic agents added to metformin reduce cardiovascular risk in Type 2 diabetes patients: a nationwide cohort observational study
Cheng-Wei Chan, Chu-Leng Yu, Jiunn-Cherng Lin, Yu-Cheng Hsieh, Che-Chen Lin, Chen-Ying Hung, Cheng-Hung Li, Ying-Chieh Liao, Chu-Pin Lo, Jin-Long Huang, Ching-Heng Lin, Tsu-Juey Wu Cardiovascular Diabetology.2018;[Epub] CrossRef - Normoglucemiantes orales y riesgo cardiovascular
Guillermo Guzmán, Juan Esteban Gómez, Leidy Johanna Plaza, María Claudia Sánchez Revista Colombiana de Cardiología.2018; 25(5): 333. CrossRef - Dipeptidyl peptidase-4 inhibitor use and risk of diabetic retinopathy: A population-based study
N.H. Kim, J. Choi, N.H. Kim, K.M. Choi, S.H. Baik, J. Lee, S.G. Kim Diabetes & Metabolism.2018; 44(4): 361. CrossRef - Obesity and Type 2 Diabetes in Our Youth: A Recipe for Cardiovascular Disease
Angela Kaye Wooton, Lynne M. Melchior The Journal for Nurse Practitioners.2017; 13(3): 222. CrossRef - Sex-gender-related therapeutic approaches for cardiovascular complications associated with diabetes
Ilaria Campesi, Flavia Franconi, Giuseppe Seghieri, Marco Meloni Pharmacological Research.2017; 119: 195. CrossRef - The Landscape of Glucose-Lowering Therapy and Cardiovascular Outcomes: From Barren Land to Metropolis
Mona P. Nasrallah, Charbel Abi Khalil, Marwan M. Refaat BioMed Research International.2017; 2017: 1. CrossRef - Articles inEndocrinology and Metabolismin 2016
Won-Young Lee Endocrinology and Metabolism.2017; 32(1): 62. CrossRef
- Clinical Study
- Triiodothyronine Levels Are Independently Associated with Metabolic Syndrome in Euthyroid Middle-Aged Subjects
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Hye Jeong Kim, Ji Cheol Bae, Hyeong Kyu Park, Dong Won Byun, Kyoil Suh, Myung Hi Yoo, Jae Hyeon Kim, Yong-Ki Min, Sun Wook Kim, Jae Hoon Chung
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Endocrinol Metab. 2016;31(2):311-319. Published online May 13, 2016
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DOI: https://doi.org/10.3803/EnM.2016.31.2.311
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- Background
Recent studies have shown an association between thyroid hormone levels and metabolic syndrome (MetS) among euthyroid individuals; however, there have been some inconsistencies between studies. Here, we evaluated the relationship between thyroid hormone levels and MetS in euthyroid middle-aged subjects in a large cohort. MethodsA retrospective analysis of 13,496 euthyroid middle-aged subjects who participated in comprehensive health examinations was performed. Subjects were grouped according to thyroid stimulating hormone, total triiodothyronine (T3), total thyroxine (T4), and T3-to-T4 ratio quartile categories. We estimated the odds ratios (ORs) for MetS according to thyroid hormone quartiles using logistic regression models, adjusted for potential confounders. ResultsOf the study patients, 12% (n=1,664) had MetS. A higher T3 level and T3-to-T4 ratio were associated with unfavourable metabolic profiles, such as higher body mass index, systolic and diastolic blood pressure, triglycerides, fasting glucose and glycated hemoglobin, and lower high density lipoprotein cholesterol levels. The proportion of participants with MetS increased across the T3 quartile categories (P for trend <0.001) and the T3-to-T4 ratio quartile categories (P for trend <0.001). The multi-variate-adjusted OR (95% confidence interval) for MetS in the highest T3 quartile group was 1.249 (1.020 to 1.529) compared to the lowest T3 quartile group, and that in the highest T3-to-T4 ratio quartile group was 1.458 (1.141 to 1.863) compared to the lowest T3-to-T4 ratio quartile group, even after adjustment for potential confounders. ConclusionSerum T3 levels and T3-to-T4 ratio are independently associated with MetS in euthyroid middle-aged subjects. Longitudinal studies are needed to define this association and its potential health implications.
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Elena Izkhakov, Nachum Vaisman, Sophie Barnes, Micha Barchana, Naftali Stern, Lital Keinan-Boker Thyroid.2019; 29(8): 1044. CrossRef - High TSH Level within Normal Range Is Associated with Obesity, Dyslipidemia, Hypertension, Inflammation, Hypercoagulability, and the Metabolic Syndrome: A Novel Cardiometabolic Marker
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Mohamed Larbi Hamlaoui, Ammar Ayachi, Aoulia Dekaken, Adel Gouri Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2018; 12(1): 1. CrossRef - High free triiodothyronine and free-triiodothyronine-to-free-thyroxine ratio levels are associated with metabolic syndrome in a euthyroid population
Diego Urrunaga-Pastor, Mirella Guarnizo-Poma, Enrique Moncada-Mapelli, Luis G. Aguirre, Herbert Lazaro-Alcantara, Socorro Paico-Palacios, Betzi Pantoja-Torres, Vicente A. Benites-Zapata Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2018; 12(2): 155. CrossRef - Exploring the association between thyroid- stimulating hormone and metabolic syndrome: A large population-based study
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Bruce H. R. Wolffenbuttel, Hanneke J. C. M. Wouters, Sandra N. Slagter, Robert P. van Waateringe, Anneke C. Muller Kobold, Jana V. van Vliet-Ostaptchouk, Thera P. Links, Melanie M. van der Klauw BMC Endocrine Disorders.2017;[Epub] CrossRef - Hormetic effect of triiodothyronine in metabolically healthy obese persons
Ji Eun Jun, Tae Hyuk Kim, Seung-Eun Lee, You-Bin Lee, Jae Hwan Jee, Ji Cheol Bae, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim, Sun Wook Kim, Jae Hoon Chung, Yong-Ki Min, Moon-Kyu Lee Endocrine.2017; 57(3): 418. CrossRef - Association of triiodothyronine levels with future development of metabolic syndrome in euthyroid middle-aged subjects: a 6-year retrospective longitudinal study
Hye Jeong Kim, Ji Cheol Bae, Hyeong Kyu Park, Dong Won Byun, Kyoil Suh, Myung Hi Yoo, Jee Jae Hwan, Jae Hyeon Kim, Yong-Ki Min, Sun Wook Kim, Jae Hoon Chung European Journal of Endocrinology.2017; 176(4): 443. CrossRef - Articles inEndocrinology and Metabolismin 2016
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- Adrenal gland
- Subclinical Cushing's Syndrome and Metabolic Disorder
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Ji Cheol Bae
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Endocrinol Metab. 2014;29(4):441-442. Published online December 29, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.4.441
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- Adrenal gland
- Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis
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Sun Mi Park, Ji Cheol Bae, Ji Young Joung, Yoon Young Cho, Tae Hun Kim, Sang-Man Jin, Sunghwan Suh, Kyu Yeon Hur, Kwang-Won Kim
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Endocrinol Metab. 2014;29(4):470-478. Published online December 29, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.4.470
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3,791
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- Background
Primary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established. MethodsMedical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were retrospectively reviewed. Based on the anatomical location, we classified the cases as adenohypophysitis (AH), infundibuloneurohypophysitis (INH), and panhypophysitis (PH). Clinical presentation, endocrine function, pathologic findings, magnetic resonance imaging findings, and treatment courses were reviewed. ResultsAmong 22 patients with primary hypophysitis, 81.8% (18/22) had involvement of the posterior pituitary lobe. Two patients of the AH (2/3, 66.6%) and three patients of the PH (3/10, 30%) groups initially underwent surgical mass reduction. Five patients, including three of the PH (3/10, 33.3%) group and one from each of the AH (1/3, 33.3%) and INH (1/9, 11.1%) groups, initially received high-dose glucocorticoid treatment. Nearly all of the patients treated with surgery or high-dose steroid treatment (9/11, 82%) required continuous hormone replacement during the follow-up period. Twelve patients received no treatment for mass reduction due to the absence of acute symptoms and signs related to a compressive mass effect. Most of them (11/12, 92%) did not show disease progression, and three patients recovered partially from hormone deficiency. ConclusionDeficits of the posterior pituitary were the most common features in our cases of primary hypophysitis. Pituitary endocrine defects responded less favorably to glucocorticoid treatment and surgery. In the absence of symptoms related to mass effect and with the mild defect of endocrine function, it may not require treatment to reduce mass except hormone replacement.
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Sunghwan Suh, Jongha Baek, Ji Cheol Bae, Kyoung-Nyoun Kim, Mi Kyoung Park, Duk Kyu Kim, Nam H. Cho, Moon-Kyu Lee
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Endocrinol Metab. 2014;29(4):522-529. Published online December 29, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.4.522
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Metabolic syndrome (MetS) is a condition characterized by a cluster of metabolic disorders and is associated with increased risk of cardiovascular disease (CVD). This study analyzed data from the Korean Health and Genome Study to examine the impact of MetS on CVD. MethodsA total of 8,898 subjects (4,241 males and 4,657 females), 40 to 69 years of age, were enrolled and evaluated for the development of new onset CVD from 2001 to 2012 (median 8.1 years of follow-up). ResultsThe prevalence of MetS at baseline was 22.0% (932/4,241) and 29.7% (1,383/4,657) in males and females, respectively. MetS was associated with increased risk of coronary heart disease (CHD; hazard ratio [HR], 1.818; 95% confidence interval [CI], 1.312 to 2.520 in males; HR, 1.789; 95% CI, 1.332 to 2.404 in females) and CVD (HR, 1.689; 95% CI, 1.295 to 2.204 in males; HR, 1.686; 95% CI, 1.007 to 2.192 in females). Specifically, MetS was associated with risk of future stroke in females only (HR, 1.486; 95% CI, 1.007 to 2.192). Among MetS components, abdominal obesity and hypertension were independent predictors of both CHD and CVD. In addition, a higher number of MetS components correlated with higher CVD risk. ConclusionMetS is a significant risk factor for the development of CVD although its impact varies between sexes.
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- Association between Serum Albumin, Insulin Resistance, and Incident Diabetes in Nondiabetic Subjects
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Ji Cheol Bae, Sung Hwan Seo, Kyu Yeon Hur, Jae Hyeon Kim, Myung-Shik Lee, Moon Kyu Lee, Won Young Lee, Eun Jung Rhee, Ki Won Oh
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Endocrinol Metab. 2013;28(1):26-32. Published online March 25, 2013
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DOI: https://doi.org/10.3803/EnM.2013.28.1.26
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- Background
Serum albumin has been suggested to be associated with insulin resistance. We evaluated the association between serum albumin concentration and insulin resistance. We also investigated whether serum albumin level has an independent effect on the development of diabetes. MethodsIn our study, 9,029 subjects without diabetes, who underwent comprehensive health check-ups annually for 5 years, were categorized into tertiles based on their serum albumin levels at baseline. The odds ratio (OR) for the prevalence of insulin resistance, defined as the top quartile of homeostasis model assessment of insulin resistance and the presence of impaired fasting glucose and nonalcoholic fatty liver disease, was evaluated cross-sectionally. Also, the hazard ratio (HR) for incident diabetes was estimated longitudinally, according to the baseline albumin tertiles using Cox proportional hazard analysis respectively. ResultsFrom the lowest to the highest tertile of albumin, the multivariable-adjusted ORs of insulin resistance increased significantly in both men and women. During the mean follow-up period of nearly 4 years, 556 (6.1%) subjects progressed to diabetes. The multivariable-adjusted HR (95% confidence interval [CI]) of diabetes in men were 1, 1.09 (95% CI, 0.86 to 1.40), and 1.10 (95% CI, 0.86 to 1.41), respectively, from the lowest to the highest tertiles of baseline albumin. Corresponding values for women were 1, 1.21 (95% CI, 0.66 to 2.21), and 1.06 (95% CI, 0.56 to 2.02), respectively. ConclusionOur study showed that increased serum albumin level was associated with insulin resistance. However, serum albumin did not have an independent effect on the development of diabetes.
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- Thyroid
- Steroid Responsive Xanthomatous Hypophysitis Associated with Autoimmune Thyroiditis: A Case Report
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Ji Young Joung, Hyemin Jeong, Yoon Young Cho, Kyoungmin Huh, Yeon-Lim Suh, Kwang-Won Kim, Ji Cheol Bae
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Endocrinol Metab. 2013;28(1):65-69. Published online March 25, 2013
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DOI: https://doi.org/10.3803/EnM.2013.28.1.65
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We report the case of a 36-year-old woman who presented with headache, fever, and amenorrhea. Laboratory analysis revealed hypopituitarism and autoimmune thyroiditis, while a cerebrospinal fluid study suggested concurrent aseptic meningitis. A magnetic resonance image (MRI) scan revealed a 1.0×0.9 cm cystic mass enlarging the sella turcica. Surgical resection via an endoscopic transsphenoidal route was performed. The histological finding of the excised tissue revealed foamy histiocytes with vacuolated cytoplasm, supporting the diagnosis of xanthomatous hypophysitis. Although a residual soft lesion was observed on the MRI image postoperatively, the patient's headache and fever improved. Ten months after surgery, the patient complained of visual impairment and headache, and the residual mass had enlarged into the suprasellar area. High dose (500 mg intravenous) methylprednisolone was administered for 3 days. During the methylprednisolone pulse therapy, the patient's visual acuity and headache improved. A follow-up MRI taken after methylprednisolone therapy showed a marked mass reduction. Our case supports an autoimmune pathophysiology for xanthomatous hypophysitis and suggests that high dose glucocorticoid therapy as a treatment option.
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