- Diabetes, obesity and metabolism
- Coronary Artery Calcium Score as a Sensitive Indicator of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus: A Long-Term Cohort Study
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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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Endocrinol Metab. 2023;38(5):568-577. Published online October 10, 2023
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DOI: https://doi.org/10.3803/EnM.2023.1770
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 Abstract
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- Background
Coronary artery calcium score (CACS) has become an important tool for evaluating cardiovascular disease (CVD). This study evaluated the significance of CACS for future CVD through more than 10 years of follow-up in asymptomatic Korean populations with type 2 diabetes mellitus (T2DM) known to have a relatively low CACS burden.
Methods
We enrolled 981 asymptomatic T2DM patients without CVD at baseline who underwent CACS evaluation using multidetector computed tomography between January 2008 and December 2014. They were grouped into five predefined CACS categories based on Agatston scores and followed up by August 2020. The primary endpoint was incident CVD events, including coronary, cerebrovascular, and peripheral arterial disease.
Results
The relative risk of CVD was significantly higher in patients with CACS ≥10, and the significance persisted after adjustment for known confounders. A higher CACS category indicated a higher incidence of future CVD: hazard ratio (95% confidence interval) 4.09 (1.79 to 9.36), 12.00 (5.61 to 25.69), and 38.79 (16.43 to 91.59) for 10≤ CACS <100, 100≤ CACS <400, and CACS ≥400, respectively. During the 12-year follow-up period, the difference in event-free survival more than doubled as the category increased. Patients with CACS below 10 had very low CVD incidence throughout the follow-up. The receiver operating characteristic analysis showed better area under curve when the CACS cutoff was 10 than 100.
Conclusion
CACS can be a sensitive marker of CVD risk. Specifically, CACS above 10 is an indicator of CVD high-risk requiring more intensive medical treatment in Koreans with T2DM.
- Obesity and Metabolism
- Recurrent Insulin Autoimmune Syndrome Caused by α-Lipoic Acid in Type 2 Diabetes
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Sang Mook Bae, Myoung Nam Bae, Eun Young Kim, Il Kyu Kim, Min Woo Seo, Jin Kyeong Shin, Sung Rae Cho, Gui Hwa Jeong
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Endocrinol Metab. 2013;28(4):326-330. Published online December 12, 2013
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DOI: https://doi.org/10.3803/EnM.2013.28.4.326
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Abstract
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Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia caused by insulin autoantibodies in the absence of exogenous insulin administration. Some drugs containing sulfhydryl compounds are known to initiate the onset of IAS. A 67-year-old female who had diabetes for 5 years visited the outpatient clinic at our institution due to diabetic peripheral polyneuropathy. She was prescribed α-lipoic acid (ALA), which contains two sulfur atoms. Two weeks later, she complained of recurrent hypoglycemic symptoms. We detected a high level of insulin and high titers of insulin autoantibodies. Her human leukocyte antigen (HLA) genotype included the DRB1*0406 allele, which indicates a high level of susceptibility to IAS. She was treated with prednisolone. After this episode, she experienced two more hypoglycemic events after taking ALA for diabetic neuropathy in other hospitals. As ALA can be used to treat diabetic peripheral polyneuropathy, physician discretion is advised based on the possibility of IAS due to ALA in diabetic patients. -
Citations
Citations to this article as recorded by  - Long-term follow-up after discharge witnesses a slow decline of insulin autoantibodies in patients with insulin autoimmune syndrome complicated with Grave’s disease: a report of two cases
Lili Zhao, Jinzhi He, Shandong Ye, Chao Chen, Jie Zhu, Chunchun Xiao, Tingni Wu, Zhicheng Liu
BMC Endocrine Disorders.2023;[Epub] CrossRef - Effects of alpha lipoic acid on metabolic syndrome: A comprehensive review
Nahid Najafi, Soghra Mehri, Mahboobeh Ghasemzadeh Rahbardar, Hossein Hosseinzadeh
Phytotherapy Research.2022; 36(6): 2300. CrossRef - Alpha-Lipoic Acid and Glucose Metabolism: A Comprehensive Update on Biochemical and Therapeutic Features
Umberto Capece, Simona Moffa, Ilaria Improta, Gianfranco Di Giuseppe, Enrico Celestino Nista, Chiara M. A. Cefalo, Francesca Cinti, Alfredo Pontecorvi, Antonio Gasbarrini, Andrea Giaccari, Teresa Mezza
Nutrients.2022; 15(1): 18. CrossRef - Analysis of the clinical characteristics of insulin autoimmune syndrome induced by alpha‐lipoic acid
Zuojun Li, Yanhong Su, Dan Yi, Cuifang Wu, Weijin Fang, Chunjiang Wang
Journal of Clinical Pharmacy and Therapeutics.2021; 46(5): 1295. CrossRef - Scientific opinion on the relationship between intake of alpha‐lipoic acid (thioctic acid) and the risk of insulin autoimmune syndrome
Dominique Turck, Jacqueline Castenmiller, Stefaan de Henauw, Karen Ildico Hirsch‐Ernst, John Kearney, Helle Katrine Knutsen, Inge Mangelsdorf, Harry J McArdle, Androniki Naska, Carmen Pelaez, Kristina Pentieva, Alfonso Siani, Frank Thies, Sophia Tsabouri,
EFSA Journal.2021;[Epub] CrossRef - Management of Insulin Autoimmune Hypoglycaemia: Single‐centre experience from Western India with systematic review of world literature
Muniraj Patel, Ravikumar Shah, Swati Ramteke‐Jadhav, Virendra Patil, Shivendra Kumar Patel, Anurag Lila, Nalini Shah, Tushar Bandgar
Clinical Endocrinology.2020; 92(5): 409. CrossRef - Glucose Changes in a Patient With Insulin Autoimmune Syndrome Demonstrated by Continuous Glucose Monitoring
Shi-Dou Lin, Shang-Ren Hsu
AACE Clinical Case Reports.2019; 5(1): e35. CrossRef - Insulin Autoimmune Syndrome in a 25-Year-Old, Previously Healthy Kuwaiti Man
Einas Alrashidi, Thamer Alessa
Case Reports in Endocrinology.2019; 2019: 1. CrossRef - Insulin autoimmune syndrome in an Argentine woman taking α-lipoic acid: A case report and review of the literature
Valentina Izzo, Carla Greco, Diana Corradini, Marco Infante, Maria Teresa Staltari, Maria Romano, Alfonso Bellia, Davide Lauro, Luigi Uccioli
SAGE Open Medical Case Reports.2018; 6: 2050313X1881960. CrossRef - Assessment and Management of Anti-Insulin Autoantibodies in Varying Presentations of Insulin Autoimmune Syndrome
David Church, Luís Cardoso, Richard G Kay, Claire L Williams, Bernard Freudenthal, Catriona Clarke, Julie Harris, Myuri Moorthy, Efthmia Karra, Fiona M Gribble, Frank Reimann, Keith Burling, Alistair J K Williams, Alia Munir, T Hugh Jones, Dagmar Führer,
The Journal of Clinical Endocrinology & Metabolism.2018; 103(10): 3845. CrossRef - Current Status of Health Foods Including Their Interactions with Drugs and Adverse Events
Yoshiro Saito
YAKUGAKU ZASSHI.2018; 138(12): 1511. CrossRef - Autoimmune hypoglycaemia caused by alpha-lipoic acid: a rare condition in Caucasian patients
A Veltroni, G Zambon, S Cingarlini, M V Davì
Endocrinology, Diabetes & Metabolism Case Reports.2018;[Epub] CrossRef - GLP‑1R agonists ameliorate peripheral nerve dysfunction and inflammation via p38 MAPK/NF‑κB signaling pathways in streptozotocin‑induced diabetic rats
Jingjing Ma, Min Shi, Xiangcheng Zhang, Xiaoning Liu, Juan Chen, Ridong Zhang, Xingzhou Wang, Hong Zhang
International Journal of Molecular Medicine.2018;[Epub] CrossRef - Insulin autoimmune syndrome associated with alpha-lipoic acid in a young woman with no concomitant disease
Sang Bae Lee, Min Young Lee, Ji Hong You, Seong Han Kim, Ji Sun Nam
Yeungnam University Journal of Medicine.2017; 34(1): 115. CrossRef - The insulin autoimmune syndrome (IAS) as a cause of hypoglycaemia: an update on the pathophysiology, biochemical investigations and diagnosis
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- Prevalence of Autoimmune Thyroid Disease and Correlation Between Thyroid Autoantibody and Acetylcholine Receptor Antibody in Myasthenia Gravis Patients.
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In Kyu Lee, Sung Rae Cho, Chan Kyu Park, Sung Jin Nam, Choo Sung Kim, Seung Yub Han, Jung Geun Lim, Sang Do Lee, Young Chun Park
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J Korean Endocr Soc. 1997;12(4):550-556. Published online January 1, 2001
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Abstract
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- BACKGROUND
There were several reports that thyroid autoimrnune disease commonly found in myasthenia gravis patients. We performed this study to determine the prevalence of thyroid autoimmune disease as well as analyze correlation between acetylcholine receptor antibody and various thyroid autoantibadies among the myasthenia gravis patients in Korea. METHOD: The patient group, 48 patients, diagnosed as myasthenia gravis from January 1985 to December 1995 at the department of Neurology, Internal medicine at Dongsan Medical Center was compaired to the control group, 40 patients, with no age and sex difference from the patient group. The samples were collected from both group for the measure of the values of acetylcholine receptor antibody, thyroid autoantibody and thyroid hormones. RESULT: 1) The values of acetylcholine receptor antibody in myasthenia gravis group and control group were 5.78+-0.7nM and 0.05+-0.06nM respectively. Of 48 patients with myasthenia gravis, 38 patients have been measured acetylcholine receptor antibody value > 0.5nM, Their mean average value was 7.24+-0.66nM. 2) The severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM and severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM showed thyroglobulin antibody value of 159.6+-79.91IU/mL versus 56.86+-32.99IU/mL. also thyroid microsomal antibody value showed 159.0+-79.9IU/mL and 23.633+-0.19IU/mL respectively. 3) Of 48 myasthenia gravis patients, 12 patients (24%) had high value of antithyroglobulin antibody or anti-microsomal antibody and 5 patients (10%) had both antibodies at the same times. In contrast, only 3 patients (8%) were observed with high value of either one of antibodies. Patient with both antibodies was not observed in normal control group. CONCLUSION: According to the datas we have obtained, appearence of the thyroid autoantibody is significantly greater in severe myasthenia gravis group than normal control group. Therefore it is suggested that the prevalence of thyroid autoimmune disease is higher in severe myasthenia gravis group than mild myasthenia gravis group or normal control group.
- Analysis of Cytokine Gene Expression in Thyroid Aspirates and Peripheral Blood Mononuclear Cell and in vitro Production of Interferon - Gamma by Peripheral Blood Mononuclear Cell Culture.
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Sung Rae Cho, Keun Yong Park, Young June Jeon, Hong Suk Song, Ki Young Kwon, Yun Nyun Kim, Seung Beom Han, In Kyu Lee
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J Korean Endocr Soc. 1995;10(1):13-25. Published online November 6, 2019
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Abstract
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- Cytokine production was studied in thyroid fine needle aspirates and peripheral blood and the production of interferon-gamma by peripheral blood mononuclear cell(PBMC) culture in response to interleukin-2(IL-2) stimulation was also studied from patients with hyperthyroidism, non toxic goiter, thyroid nodule. The expression of glycer aldehyde 3-phosphate dehydrogenase(GAPDH), interleukin-1beta(IL-1beta), IL-2, interleukin-8(IL-8), platelet- derived growth factor-A(PDGF-A) and interferon-gamma(IFN-gamma) chain was assessed by RT-PCR(reverse transcriptase polymerase chain reaction) in fine needle aspirates of thyroid and peripheral blood mononuclear cell : the samples were obtained from 7 patients with hyperthyroidism, 6 patients with non toxic goiter, 7 patients with thyroid nodule. A dose of IL-2(25 U/ml) was utilized to induce IFN-gamma production by PBMC from all patients.The results were as follows:1) In case of cytokine expression of fine-needle aspirates, GAPDH and IL-1beta, IL-8 were expressed highly but IFN-gamma, IL-2 were not expressed in hyperthyroidism and non-toxic goiter, thyroid nodule. PDGF-A was expressed in hyperthyroidism and thyroid nodule but not in non toxic goiter. 2) In case of cytokine expression of PBMC, GAPDH, IL-1beta were expressed in hyperthyroidism and non toxic goiter, thyroid nodule and highly expressed after IL-2 stimulation than before. But PDGF-A was more expressed in non toxic goiter and thyroid nodule than hyperthyroidism. Also, IFN-gamma was less expressed in thyroid nodule than hyperthyroidism and non toxic goiter. 3) The incremental increase in IFN-gamma value in supernatants of PBMC culture was significantly higher in patients with non toxic goiter than that in PBMC from hyperthyroidism and thyroid nodule(p<0.05).Therefore it seems that the cytokine production was found in hyperthyroidism and non toxic goiter and thyroid nodule. There were variability in their distribution each other, in general, higher expressed in hyperthyroidism than non toxic goiter. And RT-PCR Method that employed should be sufficiently sensitive to permit the analysis of cytokine gene expression in fine needle aspiration biopsies from patients with thyroid disease.
- Amyloid Goiter.
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Sung Rae Cho, Keun Yong Park, In Kyu Lee, Ki Lack Park, Seung Yeup Han, Young Woo Kang, Sung Bae Park, Hyun Chul Kim, Sang Pyo Kim, Kun Young Kwon
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J Korean Endocr Soc. 1994;10(2):125-130. Published online November 6, 2019
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Abstract
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- Amyloidosis is a systemic disorder of unknown etiology, The pathophysiological precess is caused by deposition of amyloid fibrils in tissues of the body. Almost any organ in the body can be affected, but amyloid goiter is a very rare presentation.A definitive diagnosis of amyloidosis requires tissue examination using special stains and electron microscopy. We had recently experienced a case of 62 year-old man who was found to have amyloid goiter after thyroid surgery.The patient was admitted Keimyung University Medical Center for evaluation of rapid growing thyroid mass and lobectomy of right thyroid gland was performed.The light microscopic finding showed eosinophilic hyalinized stroma containing one thick-walled blood wessel in the hematoxyline and eosin stain. Congo-red stain on polarized light showed apple-green birefringence of amyloid in thyroid and abdominal fat tissues. Using the PAP method, nodular deposits of amyloid in the stroma and blood vessels are stained positively with anti-AA serum. Electron microscopic finding showed randomly arranged and nonbranching fibrillary rods in the stroma.
- The incidence and causes of hypercalcemia in a hospital population.
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Jeong Mo Park, Gyeong Lyae Kim, Ho Young Pyun, Sung Rae Cho, Jun Ki Yeo, Keun Yong Park, Jeong Wook Hur, In Kyu Lee
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J Korean Endocr Soc. 1993;8(1):72-77. Published online January 1, 2001
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- No abstract available.
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