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Kyungdo Han  (Han K) 25 Articles
Diabetes, obesity and metabolism
Epidemiology and Trends of Obesity and Bariatric Surgery in Korea
Kyungdo Han, Jin-Hyung Jung, Su-Min Jeong, Mee Kyoung Kim
Endocrinol Metab. 2024;39(5):678-685.   Published online August 2, 2024
DOI: https://doi.org/10.3803/EnM.2024.2056
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  • 1 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
The prevalence of obesity in Korea has steadily increased over the past decade, reaching 38.4% in 2021. Notably, the rate of class II– III obesity, defined as a body mass index (BMI) of 30 kg/m2 or higher, exceeded 7% in the same year. Since January 2019, the National Health Insurance Service (NHIS) has provided coverage for bariatric surgery (BS) for eligible patients. Coverage is available for individuals with a BMI of 35 kg/m2 or higher, or those with a BMI of 30 kg/m2 or higher who also have obesity-related comorbidities. Additionally, partial reimbursement is offered for BS in patients with type 2 diabetes mellitus who have BMI values between 27.5 and 30 kg/m2. From 2019 to 2022, the NHIS recorded 9,080 BS procedures, with sleeve gastrectomy being the most commonly performed. The average percentage of weight loss 198±99.7 days post-surgery was 17.9%, with 80.0% of patients losing more than 10% of their body weight. This article presents the trends in obesity and BS in Korea.

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  • Impact of caloric restriction on diabetes remission in Korean adults with obesity (CREDO‐K study)
    Mee Kyoung Kim, Jinyoung Kim, Su‐Jeong Park, Yoon‐Ju Song, Hyuk‐Sang Kwon
    Diabetes, Obesity and Metabolism.2025;[Epub]     CrossRef
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Diabetes, obesity and metabolism
Impact of Chronic Kidney Disease and Gout on End-Stage Renal Disease in Type 2 Diabetes: Population-Based Cohort Study
Inha Jung, Da Young Lee, Seung Min Chung, So Young Park, Ji Hee Yu, Jun Sung Moon, Ji A Seo, Kyungdo Han, Nan Hee Kim
Endocrinol Metab. 2024;39(5):748-757.   Published online August 30, 2024
DOI: https://doi.org/10.3803/EnM.2024.2020
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We examined the impact of gout on the end-stage renal disease (ESRD) risk in patients with type 2 diabetes mellitus (T2DM) and determined whether this association differs according to chronic kidney disease (CKD) status.
Methods
Using the Korean National Health Insurance Service, this nationwide cohort study enrolled 847,884 patients with T2DM who underwent health checkups in 2009. Based on the presence of CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) and gout (two outpatient visits or one hospitalization within 5 years), patients were classified into four groups: CKDGout, CKD Gout+, CKD+Gout, and CKD+Gout+. Patients with incident ESRD were followed up until December 2018.
Results
Among 847,884 patients, 11,825 (1.4%) experienced progression to ESRD. ESRD incidence increased in the following order: 0.77 per 1,000 person-years (PY) in the CKDGout group, 1.34/1,000 PY in the CKDGout+ group, 8.20/1,000 PY in the CKD+Gout group, and 23.06/1,000 PY in the CKD+Gout+ group. The presence of gout modified the ESRD risk in a status-dependent manner. Hazard ratios (HR) were 1.49 (95% confidence interval [CI], 1.32 to 1.69) and 2.24 (95% CI, 2.09 to 2.40) in patients without and with CKD, respectively, indicating a significant interaction (P<0.0001). The CKD+Gout+ group had a markedly higher risk of developing ESRD (HR, 18.9; 95% CI, 17.58 to 20.32) than the reference group (CKDGout).
Conclusion
Gout substantially enhances the risk of ESRD, even in the absence of CKD. Concurrent CKD and gout synergistically increase the risk of ESRD. Therefore, physicians should carefully screen for hyperuricemia to prevent progression to ESRD.
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Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
Long-Term Cumulative Exposure to High γ-Glutamyl Transferase Levels and the Risk of Cardiovascular Disease: A Nationwide Population-Based Cohort Study
Han-Sang Baek, Bongseong Kim, Seung-Hwan Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Sang-Ah Chang, Kyungdo Han, Jae-Seung Yun
Endocrinol Metab. 2023;38(6):770-781.   Published online November 6, 2023
DOI: https://doi.org/10.3803/EnM.2023.1726
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  • 3 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Elevated γ-glutamyl transferase (γ-GTP) levels are associated with metabolic syndrome. We investigated the association of cumulative exposure to high γ-GTP with the risk of cardiovascular disease (CVD) in a large-scale population.
Methods
Using nationally representative data from the Korean National Health Insurance system, 1,640,127 people with 4 years of consecutive γ-GTP measurements from 2009 to 2012 were included and followed up until the end of 2019. For each year of the study period, participants were grouped by the number of exposures to the highest γ-GTP quartile (0–4), and the sum of quartiles (0–12) was defined as cumulative γ-GTP exposure. The hazard ratio for CVD was evaluated using the Cox proportional hazards model.
Results
During the 6.4 years of follow-up, there were 15,980 cases (0.97%) of myocardial infarction (MI), 14,563 (0.89%) of stroke, 29,717 (1.81%) of CVD, and 25,916 (1.58%) of death. Persistent exposure to high γ-GTP levels was associated with higher risks of MI, stroke, CVD, and death than those without such exposure. The risks of MI, stroke, CVD, and mortality increased in a dose-dependent manner according to total cumulative γ-GTP (all P for trend <0.0001). Subjects younger than 65 years, with a body mass index <25 kg/m2, and without hypertension or fatty liver showed a stronger relationship between cumulative γ-GTP and the incidence of MI, CVD, and death.
Conclusion
Cumulative γ-GTP elevation is associated with CVD. γ-GTP could be more widely used as an early marker of CVD risk, especially in individuals without traditional CVD risk factors.

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  • Interplay of serum biomarkers bilirubin and γ-glutamyltranspeptidase in predicting cardiovascular complications in type-2 diabetes mellitus
    Ebtesam Abdullah Al-Suhaimi, Abdullah Ahmed Al-Rubaish
    World Journal of Diabetes.2024; 15(6): 1074.     CrossRef
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Calcium & bone metabolism
Big Data Articles (National Health Insurance Service Database)
Association between Smoking Status and the Risk of Hip Fracture in Patients with Type 2 Diabetes: A Nationwide Population-Based Study
Se-Won Lee, Jun-Young Heu, Ju-Yeong Kim, Jinyoung Kim, Kyungdo Han, Hyuk-Sang Kwon
Endocrinol Metab. 2023;38(6):679-689.   Published online December 6, 2023
DOI: https://doi.org/10.3803/EnM.2023.1760
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  • 1 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Limited longitudinal evidence exists regarding the potential association between smoking status and hip fracture among individuals with type 2 diabetes. We investigated this association using large-scale, nationwide cohort data for the Korean population.
Methods
This nationwide cohort study included 1,414,635 adults aged 40 and older who received Korean National Health Insurance Service health examinations between 2009 and 2012. Subjects with type 2 diabetes were categorized according to their smoking status, amount smoked (pack-years), number of cigarettes smoked per day, and duration of smoking. The results are presented as hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between smoking status parameters and risk of hip fracture in multivariable Cox proportional hazard regression analysis.
Results
Compared with never-smokers, an increased adjusted HR (aHR) for hip fracture was observed in current smokers (1.681; 95% CI, 1.578 to 1.791), and a comparable aHR for hip fracture was found in former smokers (1.065; 95% CI, 0.999 to 1.136). For former smokers who had smoked 20 pack-years or more, the risk was slightly higher than that for never-smokers (aHR, 1.107; 95% CI, 1.024 to 1.196). The hip fracture risk of female former smokers was similar to that of female current smokers, but the hip fracture risk in male former smokers was similar to that of male never-smokers.
Conclusion
Smoking is associated with an increased risk of hip fracture in patients with type 2 diabetes. Current smokers with diabetes should be encouraged to quit smoking because the risk of hip fracture is greatly reduced in former smokers.

Citations

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  • Influence of quitting smoking on diabetes-related complications: A scoping review with a systematic search strategy
    Magdalena Walicka, Arkadiusz Krysiński, Giusy Rita Maria La Rosa, Ang Sun, Davide Campagna, Agostino Di Ciaula, Tabinda Dugal, Andre Kengne, Phuong Le Dinh, Anoop Misra, Riccardo Polosa, Syed Abbas Raza, Cristina Russo, Roberta Sammut, Noel Somasundaram
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2024; 18(5): 103044.     CrossRef
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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
Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee, Committee of Big Data, Korean Endocrine Society
Endocrinol Metab. 2023;38(5):525-537.   Published online September 7, 2023
DOI: https://doi.org/10.3803/EnM.2023.1765
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  • 7 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
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.

Citations

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  • Effect of glucose variability on the mortality of adults aged 75 years and over during the first year of the COVID-19 pandemic
    Miguel A. Salinero-Fort, F. Javier San Andrés-Rebollo, Juan Cárdenas-Valladolid, José Mostaza, Carlos Lahoz, Fernando Rodriguez-Artalejo, Paloma Gómez-Campelo, Pilar Vich-Pérez, Rodrigo Jiménez-García, José M. de-Miguel-Yanes, Javier Maroto-Rodriguez, Bel
    BMC Geriatrics.2024;[Epub]     CrossRef
  • Islet transplantation in Korea
    Joonyub Lee, Kun‐Ho Yoon
    Journal of Diabetes Investigation.2024; 15(9): 1165.     CrossRef
  • All-cause and cause-specific mortality risks in individuals with diabetes living alone: A large-scale population-based cohort study
    Jae-Seung Yun, Kyungdo Han, Bongseong Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Yu-Bae Ahn, Yong-Moon Mark Park, Seung-Hwan Lee
    Diabetes Research and Clinical Practice.2024; 217: 111876.     CrossRef
  • Changes in the Epidemiological Landscape of Diabetes in South Korea: Trends in Prevalence, Incidence, and Healthcare Expenditures
    Kyoung Hwa Ha, Dae Jung Kim
    Endocrinology and Metabolism.2024; 39(5): 669.     CrossRef
  • Osteoporosis incidence and its associated factors in the older Korean population: findings from a population-based cohort study
    Tanmoy Das, Md Abdullah Al Jubayer Biswas, Prosanta Mondal, Sabuj Sarker, Hyun J.“June” Lim
    Archives of Osteoporosis.2024;[Epub]     CrossRef
  • Income-Related Disparities in Mortality Among Young Adults With Type 2 Diabetes
    Ji Yoon Kim, Sojeong Park, Minae Park, Nam Hoon Kim, Sin Gon Kim
    JAMA Network Open.2024; 7(11): e2443918.     CrossRef
  • The Characteristics and Risk of Mortality in the Elderly Korean Population
    Sunghwan Suh
    Endocrinology and Metabolism.2023; 38(5): 522.     CrossRef
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Diabetes, obesity and metabolism
Risk of Pancreatic Cancer and Use of Dipeptidyl Peptidase 4 Inhibitors in Patients with Type 2 Diabetes: A Propensity Score-Matching Analysis
Mee Kyoung Kim, Kyungdo Han, Hyuk-Sang Kwon, Soon Jib Yoo
Endocrinol Metab. 2023;38(4):426-435.   Published online July 20, 2023
DOI: https://doi.org/10.3803/EnM.2023.1737
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The effects of dipeptidyl peptidase 4 (DPP-4) inhibitors over the course of long-term treatment remain unclear, and concerns have been raised regarding the role of DPP-4 inhibitors in carcinogenesis in the pancreas. Earlier studies of pancreatic adverse events have reported conflicting results.
Methods
This study analyzed Korean National Health Insurance Service data from January 2009 to December 2012. Patients who had type 2 diabetes mellitus and took two or more oral glucose-lowering drugs (GLDs) were included. Patients prescribed DPP-4 inhibitors (n=51,482) or other GLDs (n=51,482) were matched at a 1:1 ratio using propensity score matching. The risk of pancreatic cancer was calculated using Kaplan-Meier curves and Cox proportional-hazards regression analysis.
Results
During a median follow-up period of 7.95 years, 1,051 new cases of pancreatic cancer were identified. The adjusted hazard ratio (HR) for DPP-4 inhibitor use was 0.99 (95% confidence interval [CI], 0.88 to 1.12) compared with the other GLD group. In an analysis limited to cases diagnosed with pancreatic cancer during hospitalization, the adjusted HR for the use of DPP-4 inhibitors was 1.00 (95% CI, 0.86 to 1.17) compared with patients who took other GLDs. Using the other GLD group as the reference group, no trend was observed for elevated pancreatic cancer risk with increased DPP-4 inhibitor exposure.
Conclusion
In this population-based cohort study, DPP-4 inhibitor use over the course of relatively long-term follow-up showed no significant association with an elevated risk of pancreatic cancer.

Citations

Citations to this article as recorded by  
  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024; 109(12): e2317.     CrossRef
  • Anti-Diabetic Therapies and Cancer: From Bench to Bedside
    Dimitris Kounatidis, Natalia G. Vallianou, Irene Karampela, Eleni Rebelos, Marina Kouveletsou, Vasileios Dalopoulos, Petros Koufopoulos, Evanthia Diakoumopoulou, Nikolaos Tentolouris, Maria Dalamaga
    Biomolecules.2024; 14(11): 1479.     CrossRef
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Predicting the Risk of Insulin-Requiring Gestational Diabetes before Pregnancy: A Model Generated from a Nationwide Population-Based Cohort Study in Korea
Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
Endocrinol Metab. 2023;38(1):129-138.   Published online January 27, 2023
DOI: https://doi.org/10.3803/EnM.2022.1609
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AbstractAbstract PDFPubReader   ePub   
Background
The severity of gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes. We aimed to generate a risk model for predicting insulin-requiring GDM before pregnancy in Korean women.
Methods
A total of 417,210 women who received a health examination within 52 weeks before pregnancy and delivered between 2011 and 2015 were recruited from the Korean National Health Insurance database. The risk prediction model was created using a sample of 70% of the participants, while the remaining 30% were used for internal validation. Risk scores were assigned based on the hazard ratios for each risk factor in the multivariable Cox proportional hazards regression model. Six risk variables were selected, and a risk nomogram was created to estimate the risk of insulin-requiring GDM.
Results
A total of 2,891 (0.69%) women developed insulin-requiring GDM. Age, body mass index (BMI), current smoking, fasting blood glucose (FBG), total cholesterol, and γ-glutamyl transferase were significant risk factors for insulin-requiring GDM and were incorporated into the risk model. Among the variables, old age, high BMI, and high FBG level were the main contributors to an increased risk of insulin-requiring GDM. The concordance index of the risk model for predicting insulin-requiring GDM was 0.783 (95% confidence interval, 0.766 to 0.799). The validation cohort’s incidence rates for insulin-requiring GDM were consistent with the risk model’s predictions.
Conclusion
A novel risk engine was generated to predict insulin-requiring GDM among Korean women. This model may provide helpful information for identifying high-risk women and enhancing prepregnancy care.

Citations

Citations to this article as recorded by  
  • Establishment and validation of a nomogram to predict the neck contracture after skin grafting in burn patients: A multicentre cohort study
    Rui Li, Yangyang Zheng, Xijuan Fan, Zilong Cao, Qiang Yue, Jincai Fan, Cheng Gan, Hu Jiao, Liqiang Liu
    International Wound Journal.2023; 20(9): 3648.     CrossRef
  • Predicting the Need for Insulin Treatment: A Risk-Based Approach to the Management of Women with Gestational Diabetes Mellitus
    Anna S. Koefoed, H. David McIntyre, Kristen S. Gibbons, Charlotte W. Poulsen, Jens Fuglsang, Per G. Ovesen
    Reproductive Medicine.2023; 4(3): 133.     CrossRef
  • Prepregnancy Glucose Levels Within Normal Range and Its Impact on Obstetric Complications in Subsequent Pregnancy: A Population Cohort Study
    Ho Yeon Kim, Ki Hoon Ahn, Geum Joon Cho, Soon-Cheol Hong, Min-Jeong Oh, Hai-Joong Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study
    Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee
    Endocrinology and Metabolism.2023; 38(5): 525.     CrossRef
  • The CHANGED Score—A New Tool for the Prediction of Insulin Dependency in Gestational Diabetes
    Paul Rostin, Selina Balke, Dorota Sroka, Laura Fangmann, Petra Weid, Wolfgang Henrich, Josefine Theresia Königbauer
    Journal of Clinical Medicine.2023; 12(22): 7169.     CrossRef
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Thyroid
Big Data Articles (National Health Insurance Service Database)
Repeated Low High-Density Lipoprotein Cholesterol and the Risk of Thyroid Cancer: A Nationwide Population- Based Study in Korea
Jinyoung Kim, Mee Kyoung Kim, Ki-Hyun Baek, Ki-Ho Song, Kyungdo Han, Hyuk-Sang Kwon
Endocrinol Metab. 2022;37(2):303-311.   Published online April 6, 2022
DOI: https://doi.org/10.3803/EnM.2021.1332
  • 6,431 View
  • 174 Download
  • 15 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
High-density lipoprotein cholesterol (HDL-C) plays an important role in the reverse cholesterol transport pathway and prevents atherosclerosis-mediated disease. It has also been suggested that HDL-C may be a protective factor against cancer. However, an inverse correlation between HDL-C and cancer has not been established, and few studies have explored thyroid cancer.
Methods
The study participants received health checkups provided by the Korean National Health Insurance Service from 2009 to 2013 and were followed until 2019. Considering the variability of serum HDL-C level, low HDL-C level was analyzed by grouping based on four consecutive health checkups. The data analysis was performed using univariate and multivariate Cox proportional hazard regression models.
Results
A total of 3,134,278 total study participants, thyroid cancer occurred in 16,129. In the crude model, the hazard ratios for the association between repeatedly measured low HDL-C levels and thyroid cancer were 1.243, 1.404, 1.486, and 1.680 (P for trend <0.01), respectively, which were significant even after adjusting for age, sex, lifestyle factors, and metabolic diseases. The subgroup analysis revealed that low HDL-C levels likely had a greater impact on the group of patients with central obesity (P for interaction= 0.062), high blood pressure (P for interaction=0.057), impaired fasting glucose (P for interaction=0.051), and hyperlipidemia (P for interaction=0.126).
Conclusion
Repeatedly measured low HDL-C levels can be considered a risk factor for cancer as well as vascular disease. Low HDL-C levels were associated with the risk of thyroid cancer, and this correlation was stronger in a metabolically unhealthy population.

Citations

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  • Association between total cholesterol levels and all-cause mortality among newly diagnosed patients with cancer
    Seohyun Kim, Gyuri Kim, So Hyun Cho, Rosa Oh, Ji Yoon Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim
    Scientific Reports.2024;[Epub]     CrossRef
  • Association between organophosphate flame retardant exposure and lipid metabolism: data from the 2013–2014 National Health and Nutrition Examination Survey
    Fu-Jen Cheng, Kai-Fan Tsai, Kuo-Chen Huang, Chia-Te Kung, Wan-Ting Huang, Huey-Ling You, Shau-Hsuan Li, Chin-Chou Wang, Wen-Chin Lee, Hsiu-Yung Pan
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • Low serum total cholesterol levels predict inferior prognosis of patients with POEMS syndrome
    Jue Zhang, Ting Zhang, Ye Yao, Xuxing Shen, Yuanyuan Jin, Run Zhang, Lijuan Chen
    Discover Oncology.2024;[Epub]     CrossRef
  • Lipoprotein alterations in endocrine disorders - a review of the recent developments in the field
    Michal Olejarz, Ewelina Szczepanek-Parulska, Marek Ruchala
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Associations Between Metabolic Obesity Phenotypes and Pathological Characteristics of Papillary Thyroid Carcinoma
    Xiuyun Li, Xiujuan Zhang, Li Sun, Lulu Yang, Qihang Li, Zhixiang Wang, Yafei Wu, Ling Gao, Jiajun Zhao, Qingling Guo, Meng Zhou
    Endocrine Practice.2024; 30(7): 624.     CrossRef
  • Analysis of risk factors for papillary thyroid carcinoma and the association with thyroid function indicators
    Jianning Liu, Zhuoying Feng, Ru Gao, Peng Liu, Fangang Meng, Lijun Fan, Lixiang Liu, Yang Du
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Carbohydrate, Lipid, and Apolipoprotein Biomarkers in Blood and Risk of Thyroid Cancer: Findings from the AMORIS Cohort
    Xue Xiao, Yi Huang, Fetemeh Sadeghi, Maria Feychting, Niklas Hammar, Fang Fang, Zhe Zhang, Qianwei Liu
    Cancers.2023; 15(2): 520.     CrossRef
  • Altered serum lipid levels are associated with prognosis of diffuse large B cell lymphoma and influenced by utility of rituximab
    Fei Wang, Luo Lu, HuiJuan Chen, Yanhua Yue, Yanting Sun, Feng Yan, Bai He, Rongrong Lin, Weiying Gu
    Annals of Hematology.2023; 102(2): 393.     CrossRef
  • Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
    Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
    Endocrinology and Metabolism.2023; 38(1): 10.     CrossRef
  • High-density lipoprotein cholesterol and carcinogenesis
    Meijuan Tan, Shijie Yang, Xiequn Xu
    Trends in Endocrinology & Metabolism.2023; 34(5): 303.     CrossRef
  • Low Serum Cholesterol Level Is a Significant Prognostic Factor That Improves CLL-IPI in Chronic Lymphocytic Leukaemia
    Rui Gao, Kaixin Du, Jinhua Liang, Yi Xia, Jiazhu Wu, Yue Li, Bihui Pan, Li Wang, Jianyong Li, Wei Xu
    International Journal of Molecular Sciences.2023; 24(8): 7396.     CrossRef
  • Do metabolic factors increase the risk of thyroid cancer? a Mendelian randomization study
    Weiwei Liang, FangFang Sun
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Assessment of causal association between differentiated thyroid cancer and disordered serum lipid profile: a Mendelian randomization study
    Qiang Ma, Yu Li, Lijuan An, Liang Guo, Xiaokang Liu
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Risk factors and diagnostic prediction models for papillary thyroid carcinoma
    Xiaowen Zhang, Yuyang Ze, Jianfeng Sang, Xianbiao Shi, Yan Bi, Shanmei Shen, Xinlin Zhang, Dalong Zhu
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Exposure to multiple trace elements and thyroid cancer risk in Chinese adults: A case-control study
    Jia-liu He, Hua-bing Wu, Wen-lei Hu, Jian-jun Liu, Qian Zhang, Wei Xiao, Ming-jun Hu, Ming Wu, Fen Huang
    International Journal of Hygiene and Environmental Health.2022; 246: 114049.     CrossRef
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Thyroid
Big Data Articles (National Health Insurance Service Database)
Graves’ Disease and the Risk of End-Stage Renal Disease: A Korean Population-Based Study
Yoon Young Cho, Bongseong Kim, Dong Wook Shin, Hye Ryoun Jang, Bo-Yeon Kim, Chan-Hee Jung, Jae Hyeon Kim, Sun Wook Kim, Jae Hoon Chung, Kyungdo Han, Tae Hyuk Kim
Endocrinol Metab. 2022;37(2):281-289.   Published online April 6, 2022
DOI: https://doi.org/10.3803/EnM.2021.1333
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  • 143 Download
  • 3 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Background
Hyperthyroidism is associated with an increased glomerular filtration rate (GFR) in the hyperdynamic state, which is reversible after restoring euthyroidism. However, long-term follow-up of renal dysfunction in patients with hyperthyroidism has not been performed.
Methods
This was a retrospective cohort study using the Korean National Health Insurance database and biannual health checkup data. We included 41,778 Graves’ disease (GD) patients and 41,778 healthy controls, matched by age and sex. The incidences of end-stage renal disease (ESRD) were calculated in GD patients and controls. The cumulative dose and duration of antithyroid drugs (ATDs) were calculated for each patient and categorized into the highest, middle, and lowest tertiles.
Results
Among 41,778 GD patients, 55 ESRD cases occurred during 268,552 person-years of follow-up. Relative to the controls, regardless of smoking, drinking, or comorbidities, including chronic kidney disease, GD patients had a 47% lower risk of developing ESRD (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.37 to 0.76). In particular, GD patients with a higher baseline GFR (≥90 mL/min/1.73 m2; HR, 0.33; 95% CI, 0.11 to 0.99), longer treatment duration (>33 months; HR, 0.31; 95% CI, 0.17 to 0.58) or higher cumulative dose (>16,463 mg; HR, 0.29; 95% CI, 0.15 to 0.57) of ATDs had a significantly reduced risk of ESRD.
Conclusion
This was the first epidemiological study on the effect of GD on ESRD, and we demonstrated that GD population had a reduced risk for developing ESRD.

Citations

Citations to this article as recorded by  
  • Chronic Kidney Disease and Thyroid Hormones
    Yuan Cheng, Haofei Hu, Wangyang Li, Sheng Nie, Shiyu Zhou, Yuna Chen, Tao Cao, Hong Xu, Bicheng Liu, Chunbo Chen, Huafeng Liu, Qiongqiong Yang, Hua Li, Yaozhong Kong, Guisen Li, Yan Zha, Ying Hu, Gang Xu, Yongjun Shi, Yilun Zhou, Guobin Su, Ying Tang, Men
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
  • Renal function changes in patients with subclinical hyperthyroidism: a novel postulated mechanism
    Magdy Mohamed Allam, Hanaa Tarek El-Zawawy, Tarek Hussein El-Zawawy
    Endocrine.2023; 82(1): 78.     CrossRef
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    Tae Yong Kim
    Endocrinology and Metabolism.2022; 37(2): 220.     CrossRef
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    Xichao Wang, Miaomiao Zhang, Na Sun, Wenxiu Chang, Gang Chen
    Computational and Mathematical Methods in Medicine.2022; 2022: 1.     CrossRef
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Cumulative Exposure to High γ-Glutamyl Transferase Level and Risk of Diabetes: A Nationwide Population-Based Study
Ji-Yeon Park, Kyungdo Han, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim, Seung-Hwan Lee
Endocrinol Metab. 2022;37(2):272-280.   Published online April 13, 2022
DOI: https://doi.org/10.3803/EnM.2022.1416
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Elevated γ-glutamyl transferase (γ-GTP) level is associated with metabolic syndrome, impaired glucose tolerance, and insulin resistance, which are risk factors for type 2 diabetes. We aimed to investigate the association of cumulative exposure to high γ-GTP level with risk of diabetes.
Methods
Using nationally representative data from the Korean National Health Insurance system, 346,206 people who were free of diabetes and who underwent 5 consecutive health examinations from 2005 to 2009 were followed to the end of 2018. High γ-GTP level was defined as those in the highest quartile, and the number of exposures to high γ-GTP level ranged from 0 to 5. Hazard ratio (HR) and 95% confidence interval (CI) for diabetes were analyzed using the multivariable Cox proportional-hazards model.
Results
The mean follow-up duration was 9.2±1.0 years, during which 15,183 (4.4%) patients developed diabetes. There was a linear increase in the incidence rate and the risk of diabetes with cumulative exposure to high γ-GTP level. After adjusting for possible confounders, the HR of diabetes in subjects with five consecutive high γ-GTP levels were 2.60 (95% CI, 2.47 to 2.73) in men and 3.05 (95% CI, 2.73 to 3.41) in women compared with those who never had a high γ-GTP level. Similar results were observed in various subgroup and sensitivity analyses.
Conclusion
There was a linear relationship between cumulative exposure to high γ-GTP level and risk of diabetes. Monitoring and lowering γ-GTP level should be considered for prevention of diabetes in the general population.

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  • Elevated GGT to HDL ratio as a marker for the risk of NAFLD and liver fibrosis
    Yanyan Xuan, Fangfang He, Qing Liu, Dandan Dai, Dingting Wu, Yanmei Shi, Qi Yao
    Scientific Reports.2025;[Epub]     CrossRef
  • Investigating the synergistic effects of gamma-glutamyl transferase with homocysteine, ferritin, and uric acid in patients with type II diabetes mellitus
    Simin Shirvani, Masomeh Halvaeezade, Maryam Avazzade, Morteza Golbashirzadeh, Atousa Moradzadegan
    Endocrine and Metabolic Science.2025; 17: 100211.     CrossRef
  • Validation of Estimated Small Dense Low-Density Lipoprotein Cholesterol Concentration in a Japanese General Population
    Keisuke Endo, Ryo Kobayashi, Makito Tanaka, Marenao Tanaka, Yukinori Akiyama, Tatsuya Sato, Itaru Hosaka, Kei Nakata, Masayuki Koyama, Hirofumi Ohnishi, Satoshi Takahashi, Masato Furuhashi
    Journal of Atherosclerosis and Thrombosis.2024; 31(6): 931.     CrossRef
  • Risk Factors for Colorectal Adenoma and Cancer in Comprehensive Health Checkups: Usefulness of Gamma-Glutamyltransferase
    Yoko Yamanouchi, Maiko Osawa, Takaaki Senbonmatsu, Yuki Shiko, Yohei Kawasaki, Toshihiro Muramatsu
    Journal of Personalized Medicine.2024; 14(11): 1082.     CrossRef
  • Long-Term Cumulative Exposure to High γ-Glutamyl Transferase Levels and the Risk of Cardiovascular Disease: A Nationwide Population-Based Cohort Study
    Han-Sang Baek, Bongseong Kim, Seung-Hwan Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Sang-Ah Chang, Kyungdo Han, Jae-Seung Yun
    Endocrinology and Metabolism.2023; 38(6): 770.     CrossRef
  • Elevated gamma‐glutamyl transferase to high‐density lipoprotein cholesterol ratio has a non‐linear association with incident diabetes mellitus: A second analysis of a cohort study
    Haofei Hu, Yong Han, Mijie Guan, Ling Wei, Qijun Wan, Yanhua Hu
    Journal of Diabetes Investigation.2022; 13(12): 2027.     CrossRef
  • Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio: A valuable predictor of type 2 diabetes mellitus incidence
    Wangcheng Xie, Bin Liu, Yansong Tang, Tingsong Yang, Zhenshun Song
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Association of High-Density Lipoprotein Cholesterol Phenotypes with the Risk of Cardiovascular Diseases and Mortality: A Cohort Study in Korea
Ga Eun Nam, Youn Huh, Jin-Hyung Jung, Kyungdo Han, Seon Mee Kim, on Behalf of the Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity
Endocrinol Metab. 2022;37(2):261-271.   Published online April 25, 2022
DOI: https://doi.org/10.3803/EnM.2021.1259
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We investigated whether low high-density lipoprotein cholesterol (HDL-C) and isolated and non-isolated low HDL-C levels are associated with the risk of cardiovascular diseases and all-cause mortality among Korean adults.
Methods
We included 8,665,841 individuals aged ≥20 years who had undergone a health examination provided by the Korean National Health Insurance Service (NHIS) in 2009 and were followed up until the end of 2018. The hazard ratios (HRs) and 95% confidence intervals (CIs) for study outcomes were calculated using multivariable Cox proportional hazard regression analysis.
Results
During the 8.2 years of mean follow-up, myocardial infarction (MI), stroke, and all-cause mortality occurred in 81,431, 110,996, and 244,309 individuals, respectively. After adjusting for confounding variables (model 3), individuals with low HDL-C and lower HDL quartiles were associated with significantly increased risks of all three outcomes, compared to those with normal HDL-C and highest HDL-C quartile (all P<0.001), respectively. HRs for incident MI (1.28; 95% CI, 1.26 to 1.30), stroke (1.13; 95% CI, 1.11 to 1.15), and all-cause mortality (1.07; 95% CI, 1.05 to 1.08) increased in the non-isolated low HDL-C group compared to the normal HDL-C group. Isolated low HDL-C also showed an increase in the HRs of incident stroke (1.06; 95% CI, 1.04 to 1.08) and all-cause mortality (1.30; 95% CI, 1.28 to 1.32).
Conclusion
Low HDL-C and non-isolated low HDL-C were associated with increased risk of MI, stroke, and all-cause mortality, and isolated low HDL-C was associated with incident stroke and all-cause mortality risk.

Citations

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  • Association between HDL levels and stroke outcomes in the Arab population
    Aizaz Ali, Omar Obaid, Naveed Akhtar, Rahul Rao, Syed Haroon Tora, Ashfaq Shuaib
    Scientific Reports.2024;[Epub]     CrossRef
  • Association of adiposity and fitness with triglyceride-to-high-density lipoprotein cholesterol ratio in youth
    Danladi Ibrahim Musa, Abel Lamina Toriola, Nurudeen O Abubakar, Sunday Omachi, Victor B Olowoleni, Kolade B Ayodele
    Annals of Pediatric Cardiology.2023; 16(3): 194.     CrossRef
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    You-Bin Lee, Min Young Kim, Kyungdo Han, Bongsung Kim, Jiyun Park, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
    Scientific Reports.2022;[Epub]     CrossRef
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Calcium & Bone Metabolism
Big Data Articles (National Health Insurance Service Database)
Hip Fracture Risk According to Diabetic Kidney Disease Phenotype in a Korean Population
Seung Eun Lee, Juhwan Yoo, Kyoung-Ah Kim, Kyungdo Han, Han Seok Choi
Endocrinol Metab. 2022;37(1):148-158.   Published online February 28, 2022
DOI: https://doi.org/10.3803/EnM.2021.1315
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Diabetic kidney disease (DKD) is associated with an elevated risk of fractures. However, little is known about the association between proteinuric or non-proteinuric DKD and the risk of hip fracture. Thus, we investigated the incidence of hip fractures among Korean adults with type 2 diabetes mellitus (T2DM) stratified by DKD phenotype.
Methods
In this retrospective cohort study using the Korean National Health Insurance Service database, patients with T2DM who received at least one general health checkup between 2009 and 2012 were followed until the date of hip fracture, death, or December 31, 2018. We classified the DKD phenotype by proteinuria and estimated glomerular filtration rate (eGFR), as follows: no DKD (PUGFR), proteinuric DKD with normal eGFR (PU+GFR), non-proteinuric DKD with reduced eGFR (PUGFR+), and proteinuric DKD with reduced eGFR (PU+GFR+)
Results
The cumulative incidence of hip fractures was highest in the PU+GFR+ group, followed by the PUGFR+ group and the PU+GFR group. After adjustment for confounding factors, the hazard ratio (HR) for hip fracture was still highest in the PU+GFR+ group. However, the PU+GFR group had a higher HR for hip fracture than the PUGFR+ group (PU+GFR+ : HR, 1.69; 95% confidence interval [CI], 1.57 to 1.81; PU+GFR : HR, 1.37; 95% CI, 1.30 to 1.46; PUGFR+ : HR, 1.20; 95% CI, 1.16 to 1.24 using the PUGFR group as the reference category).
Conclusion
The present study demonstrated that DKD was significantly associated with a higher risk of hip fracture, with proteinuria as a major determinant.

Citations

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  • Proteinuria screening and risk of bone fracture: a retrospective cohort study using a nationwide population-based database
    Akira Okada, Akira Honda, Hideaki Watanabe, Yusuke Sasabuchi, Shotaro Aso, Kayo Ikeda Kurakawa, Masaomi Nangaku, Toshimasa Yamauchi, Hideo Yasunaga, Hirotaka Chikuda, Takashi Kadowaki, Satoko Yamaguchi
    Clinical Kidney Journal.2024;[Epub]     CrossRef
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    David Tak Wai Lui, Tingting Wu, Eric Ho Man Tang, Ivan Chi Ho Au, Chi Ho Lee, Yu Cho Woo, Kathryn Choon Beng Tan, Carlos King Ho Wong
    Diabetes Research and Clinical Practice.2023; 197: 110576.     CrossRef
  • Diagnose und Management der Osteoporose bei Diabetes mellitus (Update 2023)
    Christian Muschitz, Alexandra Kautzky-Willer, Yvonne Winhofer, Martina Rauner, Judith Haschka, Daniel Cejka, Robert Wakolbinger-Habel, Peter Pietschmann
    Wiener klinische Wochenschrift.2023; 135(S1): 207.     CrossRef
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    Seung Eun Lee, Juhwan Yoo, Bong-Seong Kim, Kyoung-Ah Kim, Kyungdo Han, Han Seok Choi
    Archives of Osteoporosis.2023;[Epub]     CrossRef
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    Seung Eun Lee, Juhwan Yoo, Han Seok Choi, Kyungdo Han, Kyoung-Ah Kim
    Diabetes & Metabolism Journal.2023; 47(4): 523.     CrossRef
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Cardiovascular Outcomes of Obesity According to Menopausal Status: A Nationwide Population-Based Study
Bo Kyung Koo, Sang-Hyun Park, Kyungdo Han, Min Kyong Moon
Endocrinol Metab. 2021;36(5):1029-1041.   Published online October 21, 2021
DOI: https://doi.org/10.3803/EnM.2021.1197
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We estimated the effect of obesity on the incidence of cardiovascular disease (CVD) and mortality in women according to menopausal status.
Methods
Women aged 40 to 69 years under routine health check-ups provided by the National Health Insurance Service in 2009 were followed up till 2018 (n=2,208,559).
Results
In premenopausal women, a significant increment of mortality rate was found in underweight and obesity class II (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.31 to 1.67; and HR, 1.25; 95% CI, 1.12 to 1.39) compared to normal body mass index (BMI); overweight and obesity class I did not affect mortality rate. In postmenopausal women, obesity as well as overweight status reduced the risk of mortality compared to normal BMI (HR, 0.86; 95% CI, 0.83 to 0.88; and HR, 0.84; 95% CI, 0.82 to 0.86). By contrast, there was a linear association between CVD and BMI above the normal range irrespective of menopausal status, which was attenuated in diabetic women.
Conclusion
The current study replicated the J-shaped relationship between BMI and mortality, being more prominent in the postmenopausal group. The risk of CVD was linearly increased as BMI was increased above the normal range irrespective of menopausal status.

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    Geetha Kandasamy, Thangamani Subramani, Gigi Sam, Mona Almanasef, Tahani Almeleebia, Eman Shorog, Asma M. Alshahrani, Amjad Hmlan, Atheer Y. Al Suhaym, Kousalya Prabahar, Vinoth Prabhu Veeramani, Palanisamy Amirthalingam
    Frontiers in Cardiovascular Medicine.2024;[Epub]     CrossRef
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    Kyungdo Han, Bongsung Kim, Seung Hwan Lee, Mee Kyoung Kim
    npj Parkinson's Disease.2023;[Epub]     CrossRef
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    Diabetes & Metabolism Journal.2023; 47(1): 45.     CrossRef
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    Do Kyeong Song, Young Sun Hong, Yeon-Ah Sung, Hyejin Lee, Aysha Almas
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    Yun Kyu Lee, Bo Kyung Koo, Sae Kyung Joo, Dong Hyeon Lee, Heejoon Jang, Jee Won Chai, Myoung Seok Lee, Si Won Jang, Young Ho So, Jeong Hwan Park, Mee Soo Chang, Won Kim
    Alimentary Pharmacology & Therapeutics.2023; 58(3): 322.     CrossRef
  • Diabetes severity is strongly associated with the risk of active tuberculosis in people with type 2 diabetes: a nationwide cohort study with a 6-year follow-up
    Ji Young Kang, Kyungdo Han, Seung-Hwan Lee, Mee Kyoung Kim
    Respiratory Research.2023;[Epub]     CrossRef
  • Effects of exercise initiation and smoking cessation after new-onset type 2 diabetes mellitus on risk of mortality and cardiovascular outcomes
    Mee Kyoung Kim, Kyungdo Han, Bongsung Kim, Jinyoung Kim, Hyuk-Sang Kwon
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    Bo Kyung Koo
    Journal of the Korean Medical Association.2022; 65(7): 400.     CrossRef
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes
Seung-Hwan Lee, Kyungdo Han, Hyuk-Sang Kwon, Mee Kyoung Kim
Endocrinol Metab. 2021;36(5):1007-1015.   Published online October 21, 2021
DOI: https://doi.org/10.3803/EnM.2021.1218
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Metabolic abnormalities, such as impaired fasting glucose (IFG), are dynamic phenomena; however, it is unclear whether the timing of IFG exposure and cumulative exposure to IFG are related to cardiovascular disease (CVD) and mortality risk.
Methods
Data were extracted from a nationwide population-based cohort in South Korea for adults (n=2,206,679) who were free of diabetes and had 4 years of consecutive health examination data. Fasting blood glucose levels of 100 to 125 mg/dL were defined as IFG, and the number of IFG diagnoses for each adult in the 4-year period was tabulated as the IFG exposure score (range, 0 to 4). Adults with persistent IFG for the 4-year period received a score of 4.
Results
The median follow-up was 8.2 years. There were 24,820 deaths, 13,502 cases of stroke, and 13,057 cases of myocardial infarction (MI). IFG exposure scores of 1, 2, 3, and 4 were associated with all-cause mortality (multivariable-adjusted hazard ratio [aHR], 1.11; 95% confidence interval [CI], 1.08 to 1.15; aHR, 1.16; 95% CI, 1.12 to 1.20; aHR, 1.20; 95% CI, 1.15 to 1.25; aHR, 1.18; 95% CI, 1.11 to 1.25, respectively) compared with an IFG exposure score of 0. Adjusting for hypertension and dyslipidemia attenuated the slightly increased risk of MI or stroke associated with high IFG exposure scores, but significant associations for allcause mortality remained.
Conclusion
The intensity of IFG exposure was associated with an elevated risk of all-cause mortality, independent of cardiovascular risk factors. The association between IFG exposure and CVD risk was largely mediated by the coexistence of dyslipidemia and hypertension.

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    Min Cheol Chang, Seung Min Chung, Sang Gyu Kwak
    Reviews on Environmental Health.2024; 39(4): 791.     CrossRef
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    Byeong Yun Ahn, Bokyung Kim, Sanghyun Park, Sang Gyun Kim, Kyungdo Han, Soo‐Jeong Cho
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  • Diabetes severity and the risk of depression: A nationwide population-based study
    Yunjung Cho, Bongsung Kim, Hyuk-Sang Kwon, Kyungdo Han, Mee Kyoung Kim
    Journal of Affective Disorders.2024; 351: 694.     CrossRef
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    Jie Liu, Feng Yi, Kai Duan, Haibo Liu
    Scientific Reports.2024;[Epub]     CrossRef
  • Impact of Cumulative Exposure to a High TG to HDL-C Ratio on Type 2 Diabetes Risk in Young Adults
    Jung Heo, Byungpyo Kim, Kyungdo Han, Hyunjyung Oh, Eun-Young Doo, Jiyeon Ahn, Seo-Young Sohn, Jae-Hyuk Lee, Min-Kyung Lee
    Journal of Clinical Lipidology.2024;[Epub]     CrossRef
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    Kyungdo Han, Bongsung Kim, Seung Hwan Lee, Mee Kyoung Kim
    npj Parkinson's Disease.2023;[Epub]     CrossRef
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    Ji Young Kang, Kyungdo Han, Seung-Hwan Lee, Mee Kyoung Kim
    Respiratory Research.2023;[Epub]     CrossRef
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    Cuicui Wang, Xu Zhang, Chenwei Li, Na Li, Xueni Jia, Hui Zhao
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    Kyungdo Han, Mee Kyoung Kim
    Journal of Obesity & Metabolic Syndrome.2023; 32(2): 163.     CrossRef
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    Jin Yu, Kyu-Na Lee, Hun-Sung Kim, Kyungdo Han, Seung-Hwan Lee
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    Myung Ji Nam, Hyunjin Kim, Yeon Joo Choi, Kyung-Hwan Cho, Seon Mee Kim, Yong-Kyun Roh, Kyungdo Han, Jin-Hyung Jung, Yong-Gyu Park, Joo-Hyun Park, Do-Hoon Kim
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    Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
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  • Lipid cutoffs for increased cardiovascular disease risk in non-diabetic young people
    Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
    European Journal of Preventive Cardiology.2022; 29(14): 1866.     CrossRef
  • Low-Density Lipoprotein Cholesterol Level, Statin Use and Myocardial Infarction Risk in Young Adults
    Heekyoung Jeong, Kyungdo Han, Soon Jib Yoo, Mee Kyoung Kim
    Journal of Lipid and Atherosclerosis.2022; 11(3): 288.     CrossRef
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    Seohyun Kim, Gyuri Kim, Jae Hyeon Kim
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Risk of Diabetes in Subjects with Positive Fecal Immunochemical Test: A Nationwide Population-Based Study
Kwang Woo Kim, Hyun Jung Lee, Kyungdo Han, Jung Min Moon, Seung Wook Hong, Eun Ae Kang, Jooyoung Lee, Hosim Soh, Seong-Joon Koh, Jong Pil Im, Joo Sung Kim
Endocrinol Metab. 2021;36(5):1069-1077.   Published online October 28, 2021
DOI: https://doi.org/10.3803/EnM.2021.1119
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AbstractAbstract PDFPubReader   ePub   
Background
Positive fecal immunochemical test (FIT) results have been recently suggested as a risk factor for systemic inflammation. Diabetes induces inflammation in the gastrointestinal tract via several ways. We investigated the association between FIT results and the incidence of diabetes.
Methods
A total of 7,946,393 individuals aged ≥50 years from the National Cancer Screening Program database who underwent FIT for colorectal cancer (CRC) screening from 2009 to 2012 were enrolled. The primary outcome was newly diagnosed diabetes based on the International Classification of Disease 10th revision codes and administration of anti-diabetic medication during the follow-up period.
Results
During a mean follow-up of 6.5 years, the incidence rates of diabetes were 11.97, 13.60, 14.53, and 16.82 per 1,000 personyears in the FIT negative, one-positive, two-positive, and three-positive groups, respectively. The hazard ratios (HRs) for the incidence of diabetes were 1.14 (95% confidence interval [CI], 1.12 to 1.16; HR, 1.21; 95% CI, 1.16 to 1.27; and HR, 1.40; 95% CI, 1.28 to 1.55) in the one-positive, two-positive, and three-positive FIT groups compared with the FIT negative group, respectively. The effect was consistent in individuals with normal fasting blood glucose (adjusted HR 1.55 vs. 1.14, P for interaction <0.001).
Conclusion
Positive FIT results were associated with a significantly higher risk of diabetes, suggesting that the FIT can play a role not only as a CRC screening tool, but also as a surrogate marker of systemic inflammation; thus, increasing the diabetes risk.

Citations

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  • Uncovering a dose-response relationship between positive fecal immunochemical test (FIT) and all-cause, cardiovascular and cancer-related mortality
    Chi Pang Wen, Min Kuang Tsai, June Han Lee, Hung Yi Chiou, Christopher Wen, Ta-Wei David Chu, Chien Hua Chen
    European Journal of Internal Medicine.2024; 120: 69.     CrossRef
  • Risk of Cancers Proximal to the Colon in Fecal Immunochemical Test Positive Screenees in a Colorectal Cancer Screening Program
    Willemijn de Klaver, Manon van der Vlugt, Manon C.W. Spaander, Patrick M. Bossuyt, Evelien Dekker
    Gastroenterology.2024; 167(4): 788.     CrossRef
  • Systematic review: Mortality associated with raised faecal immunochemical test and positive faecal occult blood results
    Francesca Ligori Malcolm, Anjali K. D. S. Yapa, Zhen Yu Wong, Alastair James Morton, Colin Crooks, Joe West, Ayan Banerjea, David Humes
    Alimentary Pharmacology & Therapeutics.2024; 60(7): 840.     CrossRef
  • Faecal haemoglobin concentrations are associated with all-cause mortality and cause of death in colorectal cancer screening
    Lasse Kaalby, Ulrik Deding, Issam Al-Najami, Gabriele Berg-Beckhoff, Thomas Bjørsum-Meyer, Tinne Laurberg, Aasma Shaukat, Robert J. C. Steele, Anastasios Koulaouzidis, Morten Rasmussen, Morten Kobaek-Larsen, Gunnar Baatrup
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    Yu Kyung Jun, Seung Woo Lee, Kwang Woo Kim, Jung Min Moon, Seong-Joon Koh, Hyun Jung Lee, Joo Sung Kim, Kyungdo Han, Jong Pil Im
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    Karen N. Barnett, Gavin R. C. Clark, Robert J. C. Steele, Callum G. Fraser
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
Endocrinol Metab. 2021;36(3):628-636.   Published online May 26, 2021
DOI: https://doi.org/10.3803/EnM.2020.948
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To investigate the clinical characteristics of gestational diabetes mellitus (GDM) in Korea, using a nationwide database.
Methods
We analyzed 417,139 women who gave birth between 2011 and 2015 using the Korean National Health Information Database. They underwent the Korean National Health Screening Program within one year before pregnancy and were not prescribed drugs for diabetes nor diagnosed with diabetes mellitus before 280 days antepartum. Patients with GDM were defined as those who visited the outpatient clinic more than twice with GDM codes.
Results
The prevalence of GDM was 12.70% and increased with increasing maternal age, prepregnancy body mass index (BMI), waist circumference (WC), and fasting plasma glucose (FPG) (P for trend <0.05). As compared with those aged <25 years, the odds ratio for women with GDM aged ≥40 years were 4.804 (95% confidence interval [CI], 4.436 to 5.203) after adjustment for covariates. Women with prepregnancy BMI ≥30 kg/m2 were at 1.898 times (95% CI, 1.736 to 2.075) greater risk for GDM than those with prepregnancy BMI <18.5 kg/m2. Women with WC of ≥95 cm were at 1.158 times (95% CI, 1.029 to 1.191) greater risk for GDM than women with WC of less than 65 cm. High FPG, high income, smoking, and drinking were associated with an elevated risk of GDM.
Conclusion
The prevalence of GDM in Korean women increased up to 12.70% during 2011 to 2015. These data suggest the importance of GDM screening and prevention in high-risk groups in Korea.

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  • Circulating fibroblast growth factor 21 levels in gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis
    Zhen Cao, Zhiming Deng, Jieyi Lu, Ying Yuan
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    Joon Ho Moon, Hak Chul Jang
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    Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
    Diabetes & Metabolism Journal.2022; 46(4): 552.     CrossRef
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Close layer
Clinical Study
Big Data Articles (National Health Insurance Service Database)
Cumulative Exposure to Metabolic Syndrome Components and the Risk of Dementia: A Nationwide Population-Based Study
Yunjung Cho, Kyungdo Han, Da Hye Kim, Yong-Moon Park, Kun-Ho Yoon, Mee Kyoung Kim, Seung-Hwan Lee
Endocrinol Metab. 2021;36(2):424-435.   Published online April 14, 2021
DOI: https://doi.org/10.3803/EnM.2020.935
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  • 15 Web of Science
  • 16 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Metabolic disturbances are modifiable risk factors for dementia. Because the status of metabolic syndrome (MetS) and its components changes over time, we aimed to investigate the association of the cumulative exposure to MetS and its components with the risk of dementia.
Methods
Adults (n=1,492,776; ≥45-years-old) who received health examinations for 4 consecutive years were identified from a nationwide population-based cohort in Korea. Two exposure-weighted scores were calculated: cumulative number of MetS diagnoses (MetS exposure score, range of 0 to 4) and the composite of its five components (MetS component exposure score, range of 0 to 20). Hazard ratio (HR) and 95% confidence interval (CI) values for dementia were analyzed using the multivariable Cox proportional-hazards model.
Results
Overall, 47.1% of subjects were diagnosed with MetS at least once, and 11.5% had persistent MetS. During the mean 5.2 years of follow-up, there were 7,341 cases (0.5%) of incident dementia. There was a stepwise increase in the risk of all-cause dementia, Alzheimer’s disease, and vascular dementia with increasing MetS exposure score and MetS component exposure score (each P for trend <0.0001). The HR of all-cause dementia was 2.62 (95% CI, 1.87 to 3.68) in subjects with a MetS component exposure score of 20 compared with those with a score of 0. People fulfilling only one MetS component out of 20 already had an approximately 40% increased risk of all-cause dementia and Alzheimer’s disease.
Conclusion
More cumulative exposure to metabolic disturbances was associated with a higher risk of dementia. Of note, even minimal exposure to MetS components had a significant effect on the risk of dementia.

Citations

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    Yu Meng Tian, Wei Sen Zhang, Chao Qiang Jiang, Feng Zhu, Ya Li Jin, Shiu Lun Au Yeung, Jiao Wang, Kar Keung Cheng, Tai Hing Lam, Lin Xu
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    Tara SR Chen, Ning-Ning Mi, Hubert Yuenhei Lao, Chen-Yu Wang, Wai Leung Ambrose Lo, Yu-Rong Mao, Yan Tang, Zhong Pei, Jin-Qiu Yuan, Dong-Feng Huang
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    Nabil J. Alkayed
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    Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
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    Walaa Fakih, Ralph Zeitoun, Ibrahim AlZaim, Ali H. Eid, Firas Kobeissy, Khaled S. Abd‐Elrahman, Ahmed F. El‐Yazbi
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    Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
    Diabetes & Metabolism Journal.2022; 46(4): 552.     CrossRef
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    Marcos D. Machado-Fragua, Aurore Fayosse, Manasa Shanta Yerramalla, Thomas T. van Sloten, Adam G. Tabak, Mika Kivimaki, Séverine Sabia, Archana Singh-Manoux
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    Sangmo Hong, Kyungdo Han, Kyung-Soo Kim, Cheol-Young Park
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Clinical Study
Big Data Articles (National Health Insurance Service Database)
Variabilities in Weight and Waist Circumference and Risk of Myocardial Infarction, Stroke, and Mortality: A Nationwide Cohort Study
Da Hye Kim, Ga Eun Nam, Kyungdo Han, Yang-Hyun Kim, Kye-Yeung Park, Hwan-Sik Hwang, Byoungduck Han, Sung Jung Cho, Seung Jin Jung, Yeo-Joon Yoon, Yong Kyun Roh, Kyung Hwan Cho, Yong Gyu Park
Endocrinol Metab. 2020;35(4):933-942.   Published online December 23, 2020
DOI: https://doi.org/10.3803/EnM.2020.871
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  • 18 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Evidence regarding the association between variabilities in obesity measures and health outcomes is limited. We aimed to examine the association between variabilities in obesity measures and cardiovascular outcomes and all-cause mortality.
Methods
We identified 4,244,460 individuals who underwent health examination conducted by the Korean National Health Insurance Service during 2012, with ≥3 anthropometric measurements between 2009 and 2012. Variabilities in body weight (BW) and waist circumference (WC) were assessed using four indices including variability independent of the mean (VIM). We performed multivariable Cox proportional hazards regression analyses.
Results
During follow-up of 4.4 years, 16,095, 18,957, and 30,200 cases of myocardial infarction (MI), stroke, and all-cause mortality were recorded. Compared to individuals with the lowest quartiles, incrementally higher risks of study outcomes and those of stroke and all-cause mortality were observed among individuals in higher quartiles of VIM for BW and VIM for WC, respectively. The multivariable adjusted hazard ratios and 95% confidence intervals comparing the highest versus lowest quartile groups of VIM for BW were 1.17 (1.12 to 1.22) for MI, 1.20 (1.16 to 1.25) for stroke, and 1.66 (1.60 to 1.71) for all-cause mortality; 1.07 (1.03 to 1.12) for stroke and 1.29 (1.25 to 1.33) for all-cause mortality regarding VIM for WC. These associations were similar with respect to the other indices for variability.
Conclusion
This study revealed positive associations between variabilities in BW and WC and cardiovascular outcomes and allcause mortality. Our findings suggest that variabilities in obesity measures are associated with adverse health outcomes in the general population.

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  • Gender differences in midlife to later-life cumulative burden and variability of obesity measures and risk of all-cause and cause-specific mortality
    Karim Kohansal, Siamak Afaghi, Davood Khalili, Danial Molavizadeh, Farzad Hadaegh
    International Journal of Obesity.2024; 48(4): 495.     CrossRef
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    Stephen Fava, Sascha Reiff
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    Clinton David Orupabo, Solomon David Owualah, Iberedem Clinton David
    International Journal of Medicine and Medical Research.2024; 10(1): 23.     CrossRef
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    Sang Min Lee, Minha Hong, Jae-Hong Ryoo
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    Lei Liu, Xiaojia Xue, Hua Zhang, Xiaocao Tian, Yunhui Chen, Yu Guo, Pei Pei, Shaojie Wang, Haiping Duan, Ruqin Gao, Zengchang Pang, Zhengming Chen, Liming Li
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    Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
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    Eun-Jung Rhee
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    Min Jeong Park, Kyung Mook Choi
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    Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
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    Chrissa Sioka, Paraskevi Zotou, Michail I. Papafaklis, Aris Bechlioulis, Konstantinos Sakellariou, Aidonis Rammos, Evangelia Gkika, Lampros Lakkas, Sotiria Alexiou, Pavlos Kekiopoulos, Katerina K. Naka, Christos Katsouras
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    Daniel Nyarko Hukportie, Fu-Rong Li, Rui Zhou, Jia-Zhen Zheng, Xiao-Xiang Wu, Xian-Bo Wu
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    Sang Youn You, Kyungdo Han, Seung-Hawn Lee, Mee Kyoung Kim
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  • Increased Risk of Nonalcoholic Fatty Liver Disease in Individuals with High Weight Variability
    Inha Jung, Dae-Jeong Koo, Mi Yeon Lee, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
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Clinical Study
Predicting the Development of Myocardial Infarction in Middle-Aged Adults with Type 2 Diabetes: A Risk Model Generated from a Nationwide Population-Based Cohort Study in Korea
Seung-Hwan Lee, Kyungdo Han, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
Endocrinol Metab. 2020;35(3):636-646.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.704
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  • 122 Download
  • 12 Web of Science
  • 14 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Most of the widely used prediction models for cardiovascular disease are known to overestimate the risk of this disease in Asians. We aimed to generate a risk model for predicting myocardial infarction (MI) in middle-aged Korean subjects with type 2 diabetes.
Methods
A total of 1,272,992 subjects with type 2 diabetes aged 40 to 64 who received health examinations from 2009 to 2012 were recruited from the Korean National Health Insurance database. Seventy percent of the subjects (n=891,095) were sampled to develop the risk prediction model, and the remaining 30% (n=381,897) were used for internal validation. A Cox proportional hazards regression model and Cox coefficients were used to derive a risk scoring system. Twelve risk variables were selected, and a risk nomogram was created to estimate the 5-year risk of MI.
Results
During 7.1 years of follow-up, 24,809 cases of MI (1.9%) were observed. Age, sex, smoking status, regular exercise, body mass index, chronic kidney disease, duration of diabetes, number of anti-diabetic medications, fasting blood glucose, systolic blood pressure, total cholesterol, and atrial fibrillation were significant risk factors for the development of MI and were incorporated into the risk model. The concordance index for MI prediction was 0.682 (95% confidence interval [CI], 0.678 to 0.686) in the development cohort and 0.669 (95% CI, 0.663 to 0.675) in the validation cohort.
Conclusion
A novel risk engine was generated for predicting the development of MI among middle-aged Korean adults with type 2 diabetes. This model may provide useful information for identifying high-risk patients and improving quality of care.

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  • Overcoming Missing Data: Accurately Predicting Cardiovascular Risk in Type 2 Diabetes, A Systematic Review
    Wenhui Ren, Keyu Fan, Zheng Liu, Yanqiu Wu, Haiyan An, Huixin Liu
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  • A literature review of quality assessment and applicability to HTA of risk prediction models of coronary heart disease in patients with diabetes
    Li Jiu, Junfeng Wang, Francisco Javier Somolinos-Simón, Jose Tapia-Galisteo, Gema García-Sáez, Mariaelena Hernando, Xinyu Li, Rick A. Vreman, Aukje K. Mantel-Teeuwisse, Wim G. Goettsch
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  • Predicting the Risk of Insulin-Requiring Gestational Diabetes before Pregnancy: A Model Generated from a Nationwide Population-Based Cohort Study in Korea
    Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
    Endocrinology and Metabolism.2023; 38(1): 129.     CrossRef
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    Kyungdo Han, Mee Kyoung Kim
    Journal of Obesity & Metabolic Syndrome.2023; 32(2): 163.     CrossRef
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    Dae-Jeong Koo, Mi Yeon Lee, Sun Joon Moon, Hyemi Kwon, Sang Min Lee, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki Won Oh, Sung Rae Cho, Young-Hoon Jeong, Eun-Jung Rhee
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    Mee Kyoung Kim, Kyungdo Han, Bongsung Kim, Jinyoung Kim, Hyuk-Sang Kwon
    Scientific Reports.2022;[Epub]     CrossRef
  • Current Trends of Big Data Research Using the Korean National Health Information Database
    Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
    Diabetes & Metabolism Journal.2022; 46(4): 552.     CrossRef
  • Lipid cutoffs for increased cardiovascular disease risk in non-diabetic young people
    Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
    European Journal of Preventive Cardiology.2022; 29(14): 1866.     CrossRef
  • Low-Density Lipoprotein Cholesterol Level, Statin Use and Myocardial Infarction Risk in Young Adults
    Heekyoung Jeong, Kyungdo Han, Soon Jib Yoo, Mee Kyoung Kim
    Journal of Lipid and Atherosclerosis.2022; 11(3): 288.     CrossRef
  • Nonalcoholic fatty liver disease and the risk of insulin-requiring gestational diabetes
    Sang Youn You, Kyungdo Han, Seung-Hawn Lee, Mee Kyoung Kim
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Close layer
Clinical Study
Impact of the Dynamic Change of Metabolic Health Status on the Incident Type 2 Diabetes: A Nationwide Population-Based Cohort Study
Jung A Kim, Da Hye Kim, Seon Mee Kim, Yong Gyu Park, Nan Hee Kim, Sei Hyun Baik, Kyung Mook Choi, Kyungdo Han, Hye Jin Yoo
Endocrinol Metab. 2019;34(4):406-414.   Published online December 23, 2019
DOI: https://doi.org/10.3803/EnM.2019.34.4.406
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  • 18 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals.

Methods

We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO.

Results

During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain.

Conclusion

Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index.

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    Daye Diana Choi, Kyung-Ah Park, Kyungdo Han, Sei Yeul Oh
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Obesity and Metabolism
Comparison of the Effects of Ezetimibe-Statin Combination Therapy on Major Adverse Cardiovascular Events in Patients with and without Diabetes: A Meta-Analysis
Namki Hong, Yong-ho Lee, Kenichi Tsujita, Jorge A. Gonzalez, Christopher M. Kramer, Tomas Kovarnik, George N. Kouvelos, Hiromichi Suzuki, Kyungdo Han, Chan Joo Lee, Sung Ha Park, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang
Endocrinol Metab. 2018;33(2):219-227.   Published online May 4, 2018
DOI: https://doi.org/10.3803/EnM.2018.33.2.219
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  • 21 Web of Science
  • 19 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Ezetimibe-statin combination therapy has been found to reduce low density lipoprotein cholesterol levels and the risk of major adverse cardiovascular events (MACEs) in large trials. We sought to examine the differential effect of ezetimibe on MACEs when added to statins according to the presence of diabetes.

Methods

Randomized clinical trials with a sample size of at least 50 participants and at least 24 weeks of follow-up that compared ezetimibe-statin combination therapy with a statin- or placebo-controlled arm and reported at least one MACE, stratified by diabetes status, were included in the meta-analysis and meta-regression.

Results

A total of seven trials with 28,191 enrolled patients (mean age, 63.6 years; 75.1% men; 7,298 with diabetes [25.9%]; mean follow-up, 5 years) were analysed. MACEs stratified by diabetes were obtained from the published data (two trials) or through direct contact (five trials). No significant heterogeneity was observed among studies (I2=14.7%, P=0.293). Ezetimibe was associated with a greater reduction of MACE risk in subjects with diabetes than in those without diabetes (pooled relative risk, 0.84 vs. 0.93; Pheterogeneity=0.012). In the meta-regression analysis, the presence of diabetes was associated with a greater reduction of MACE risk when ezetimibe was added to statins (β=0.87, P=0.038).

Conclusion

Ezetimibe-statin combination therapy was associated with greater cardiovascular benefits in patients with diabetes than in those without diabetes. Our findings suggest that ezetimibe-statin combination therapy might be a useful strategy in patients with diabetes at a residual risk of MACEs.

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Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012
Kyung Min Ko, Kyungdo Han, Youn Jee Chung, Kun-Ho Yoon, Yong Gyu Park, Seung-Hwan Lee
Endocrinol Metab. 2017;32(2):248-256.   Published online June 23, 2017
DOI: https://doi.org/10.3803/EnM.2017.32.2.248
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  • 14 Web of Science
  • 16 Crossref
AbstractAbstract PDFPubReader   
Background

Menstrual irregularity is an indicator of endocrine disorders and reproductive health status. It is associated with various diseases and medical conditions, including obesity and underweight. We aimed to assess the association between body weight changes and menstrual irregularity in Korean women.

Methods

A total of 4,621 women 19 to 54 years of age who participated in the 2010 to 2012 Korea National Health and Nutrition Examination Survey were included in this study. Self-reported questionnaires were used to collect medical information assessing menstrual health status and body weight changes. Odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between body weight changes and menstrual irregularity.

Results

Significantly higher ORs (95% CI) were observed in the association between menstrual irregularity and both weight loss (OR, 1.74; 95% CI, 1.22 to 2.48) and weight gain (OR, 1.45; 95% CI, 1.13 to 1.86) after adjusting for age, body mass index, current smoking, heavy alcohol drinking, regular exercise, calorie intake, education, income, metabolic syndrome, age of menarche, parity, and stress perception. Of note, significant associations were only observed in subjects with obesity and abdominal obesity, but not in non-obese or non-abdominally obese subjects. U-shaped patterns were demonstrated in both obese and abdominally obese subjects, indicating that greater changes in body weight are associated with higher odds of menstrual irregularity.

Conclusion

We found a U-shaped pattern of association between body weight changes and menstrual irregularity among obese women in the general Korean population. This result indicates that not only proper weight management but also changes in body weight may influence the regulation of the menstrual cycle.

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Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study
Hye Yeon Koo, In Young Cho, Yoo Jin Um, Yong-Moon Mark Park, Kyung Mee Kim, Chung Eun Lee, Kyungdo Han
Received July 31, 2024  Accepted October 15, 2024  Published online November 20, 2024  
DOI: https://doi.org/10.3803/EnM.2024.2126    [Epub ahead of print]
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations.
Methods
This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID.
Results
Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001).
Conclusion
Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.
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Time to Insulin Therapy and Severe Hypoglycemia in Korean Adults Initially Diagnosed with Type 2 Diabetes: A Nationwide Study
You-Bin Lee, Kyungdo Han, Bongsung Kim, So Hee Park, Kyu Yeon Hur, Gyuri Kim, Jae Hyeon Kim, Sang-Man Jin
Received July 4, 2024  Accepted November 19, 2024  Published online February 4, 2025  
DOI: https://doi.org/10.3803/EnM.2024.2082    [Epub ahead of print]
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  • 3 Download
AbstractAbstract PDF
Background
We examined the distribution of time to insulin therapy (TIT) post-diabetes diagnosis and the hazard of severe hypoglycemia (SH) according to TIT in Korean adults initially diagnosed with type 2 diabetes (T2D) and who progressed to insulin therapy.
Methods
Using data from the Korean National Health Insurance Service (2002 to 2018), we selected adult incident insulin users (initially diagnosed as T2D) who underwent health examinations between 2009 and 2012. The hazards of SH, recurrent SH, and problematic hypoglycemia were analyzed according to groups categorized using the TIT and clinical risk factors for SH (TIT ≥5 years with risk factors, TIT ≥5 years without risk factors, 3 ≤TIT <5 years, 1 ≤TIT <3 years, and TIT <1 year).
Results
Among 41,637 individuals, 14,840 (35.64%) and 10,587 (25.43%) initiated insulin therapy within <5 and <3 years postdiabetes diagnosis, respectively. During a median 6.53 years, 3,406 SH events occurred. Compared to individuals with TIT ≥5 years and no risk factor for SH, individuals with TIT <3 years had higher outcome hazards in a graded manner (adjusted hazard ratio [95% confidence intervals] for any SH: 1.117 [0.967 to 1.290] in those with 3 ≤TIT <5 years; 1.459 [1.284 to 1.657] in those with 1 ≤ TIT <3 years; and 1.515 [1.309 to 1.754] in those with TIT <1 year). This relationship was more pronounced in the non-obese subpopulation.
Conclusion
Among adults who progressed to insulin therapy after being diagnosed with T2D, a shorter TIT was not uncommon and may predict an increased risk of SH, particularly in non-obese patients.
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Long-Term Prognosis and Systemic Impact of Acromegaly: Analyses Utilizing Korean National Health Insurance Data
Sangmo Hong, Kyungdo Han, Cheol-Young Park
Received December 19, 2024  Accepted January 26, 2025  Published online February 4, 2025  
DOI: https://doi.org/10.3803/EnM.2024.2285    [Epub ahead of print]
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  • 25 Download
AbstractAbstract PDF
Acromegaly is a rare endocrine disorder caused by excessive growth hormone secretion. Its low prevalence poses challenges in studying its long-term prognosis and systemic effects. To address this research gap, we conducted five studies using nationwide cohort data from the Korean National Health Insurance Database (NHID). This review consolidates the findings of these studies, which examined various long-term effects of acromegaly. The results demonstrated significant associations between acromegaly and increased mortality, a higher prevalence of mortality, cardiovascular outcomes, neurodegenerative diseases, depression, end-stage kidney disease, respiratory complications, specifically bronchiectasis, spine & hip fracture and malignancy. These findings highlight the critical need for early diagnosis, comprehensive care, and long-term monitoring, and underscore the importance of a multidisciplinary approach in managing acromegaly.
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