- Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
- Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study
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Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee, Committee of Big Data, Korean Endocrine Society
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Endocrinol Metab. 2023;38(5):525-537. Published online September 7, 2023
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DOI: https://doi.org/10.3803/EnM.2023.1765
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Abstract
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- Background
This study investigated the risk of cause-specific mortality according to glucose tolerance status in elderly South Koreans.
Methods A total of 1,292,264 individuals aged ≥65 years who received health examinations in 2009 were identified from the National Health Information Database. Participants were classified as normal glucose tolerance, impaired fasting glucose, newly-diagnosed diabetes, early diabetes (oral hypoglycemic agents ≤2), or advanced diabetes (oral hypoglycemic agents ≥3 or insulin). The risk of system-specific and disease-specific deaths was estimated using multivariate Cox proportional hazards analysis.
Results During a median follow-up of 8.41 years, 257,356 deaths were recorded. Diabetes was associated with significantly higher risk of all-cause mortality (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.57 to 1.60); death due to circulatory (HR, 1.49; 95% CI, 1.46 to 1.52), respiratory (HR, 1.51; 95% CI, 1.47 to 1.55), and genitourinary systems (HR, 2.22; 95% CI, 2.10 to 2.35); and neoplasms (HR, 1.30; 95% CI, 1.28 to 1.32). Diabetes was also associated with a significantly higher risk of death due to ischemic heart disease (HR, 1.70; 95% CI, 1.63 to 1.76), cerebrovascular disease (HR, 1.46; 95% CI, 1.41 to 1.50), pneumonia (HR, 1.69; 95% CI, 1.63 to 1.76), and acute or chronic kidney disease (HR, 2.23; 95% CI, 2.09 to 2.38). There was a stepwise increase in the risk of death across the glucose spectrum (P for trend <0.0001). Stroke, heart failure, or chronic kidney disease increased the risk of all-cause mortality at every stage of glucose intolerance.
Conclusion A dose-dependent association between the risk of mortality from various causes and severity of glucose tolerance was noted in the elderly population.
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Citations
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- The Characteristics and Risk of Mortality in the Elderly Korean Population
Sunghwan Suh Endocrinology and Metabolism.2023; 38(5): 522. CrossRef
- Clinical Study
- Impaired Cortisol and Growth Hormone Counterregulatory Responses among Severe Hypoglycemic Patients with Type 2 Diabetes Mellitus
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Young A Rhyu, Ju-Young Jang, Sooyoun Park, Jee Hyun An, Dong-Lim Kim, Suk Kyeong Kim, Kee-Ho Song
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Endocrinol Metab. 2019;34(2):187-194. Published online June 24, 2019
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DOI: https://doi.org/10.3803/EnM.2019.34.2.187
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5,051
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Abstract
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- Background
Elevated levels of cortisol and growth hormone are critical counterregulatory responses to severe hypoglycemia. However, the proportion and clinical characteristics of patients with type 2 diabetes mellitus (DM) who fail to show appropriate cortisol and/or growth hormone secretion in response to severe hypoglycemia have not been investigated. MethodsWe measured plasma cortisol and growth hormone levels in type 2 DM patients with severe hypoglycemia who visited the emergency department between 2006 and 2015. ResultsOf 112 hypoglycemic patients, 23 (20.5%) had an impaired cortisol response (<18 µg/dL) and 82 patients (73.2%) had an impaired growth hormone response (<5 ng/mL). Nineteen patients (17.0%) had impaired responses to both cortisol and growth hormone. The patients with impaired responses of cortisol, growth hormone, and both hormones were significantly older and more likely to be female, and had higher admission rates, lower growth hormone levels, and lower adrenocorticotropic hormone levels than the patients with a normal hormonal response. Multivariate logistic regression analysis indicated that an impaired growth hormone response was significantly associated with advanced age, shorter DM duration, a higher admission rate, and a higher body mass index (BMI). An impaired cortisol response was significantly associated with growth hormone levels. Patients with an impaired growth hormone response had higher admission rates than patients with a normal response. ConclusionA considerable number of type 2 DM patients had impaired cortisol and/or growth hormone responses to severe hypoglycemia. Advanced age, shorter DM duration, and higher BMI were independently associated with an abnormal growth hormone response.
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Citations
Citations to this article as recorded by
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Rana A. Ali, Eatemad A. Awadalla, Yahia A. Amin, Samer S. Fouad, Maha Abd-El Baki Ahmed, Mohammed H. Hassan, Emaad Abdel-Kahaar, Rehab H. Abdel-Aziz Scientific Reports.2024;[Epub] CrossRef - Prediabetes and mild hepatosteatosis are associated with blunted cortisol response to glucagon but not to growth hormone
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María Eugenia Gullace, María Victoria Ortuño, Teresa Mabel Canteros, Belén Bosco, Cintia Rodriguez, Javier Giunta, Lucas Costa, Andrea Kozak, Valeria de Miguel, Luis Grosembacher Endocrinología, Diabetes y Nutrición (English ed.).2023; 70(10): 634. CrossRef - Cerebrospinal fluid levels of hypothalamic-pituitary-adrenal axis hormones in MCI and dementia due to Alzheimer’s disease: a systematic review
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