- Diabetes, obesity and metabolism
- Glucocorticoid-Induced Hyperglycemia: A Neglected Problem
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Jung-Hwan Cho, Sunghwan Suh
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Endocrinol Metab. 2024;39(2):222-238. Published online March 27, 2024
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DOI: https://doi.org/10.3803/EnM.2024.1951
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Abstract
PDFPubReader ePub
- Glucocorticoids provide a potent therapeutic response and are widely used to treat a variety of diseases, including coronavirus disease 2019 (COVID-19) infection. However, the issue of glucocorticoid-induced hyperglycemia (GIH), which is observed in over one-third of patients treated with glucocorticoids, is often neglected. To improve the clinical course and prognosis of diseases that necessitate glucocorticoid therapy, proper management of GIH is essential. The key pathophysiology of GIH includes systemic insulin resistance, which exacerbates hepatic steatosis and visceral obesity, as well as proteolysis and lipolysis of muscle and adipose tissue, coupled with β-cell dysfunction. For patients on glucocorticoid therapy, risk stratification should be conducted through a detailed baseline evaluation, and frequent glucose monitoring is recommended to detect the onset of GIH, particularly in high-risk individuals. Patients with confirmed GIH who require treatment should follow an insulin-centered regimen that varies depending on whether they are inpatients or outpatients, as well as the type and dosage of glucocorticoid used. The ideal strategy to maintain normoglycemia while preventing hypoglycemia is to combine basal-bolus insulin and correction doses with a continuous glucose monitoring system. This review focuses on the current understanding and latest evidence concerning GIH, incorporating insights gained from the COVID-19 pandemic.
- Diabetes, obesity and metabolism
- The Characteristics and Risk of Mortality in the Elderly Korean Population
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Sunghwan Suh
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Endocrinol Metab. 2023;38(5):522-524. Published online October 23, 2023
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DOI: https://doi.org/10.3803/EnM.2023.502
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- Diabetes, obesity and metabolism
- Greater Severity of Steatosis Is Associated with a Higher Risk of Incident Diabetes: A Retrospective Longitudinal Study
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Ji Min Han, Jung Hwan Cho, Hye In Kim, Sunghwan Suh, Yu-Ji Lee, Jung Won Lee, Kwang Min Kim, Ji Cheol Bae
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Endocrinol Metab. 2023;38(4):418-425. Published online July 12, 2023
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DOI: https://doi.org/10.3803/EnM.2023.1729
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Abstract
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- Background
Fatty liver is associated with increased risk of developing type 2 diabetes. We aimed to evaluate whether the severity of hepatic steatosis is associated with incident diabetes.
Methods We conducted a longitudinal analysis using data from 1,798 participants who underwent a comprehensive health checkup and abdominal computed tomography (CT). We assessed the association between baseline liver attenuation value on non-contrast CT images and risk of incident diabetes. All the participants were categorized into three groups based on the baseline liver attenuation value on non-contrast CT images: without hepatic steatosis (>57 Hounsfield unit [HU]), mild hepatic steatosis (41–57 HU), and moderate to severe hepatic steatosis (≤40 HU).
Results During a median follow-up period of 5 years, 6.0% of the study participants progressed to diabetes. The incidence of diabetes was 17.3% in the moderate to severe hepatic steatosis group, 9.0% in the mild steatosis group, and 2.9% in those without hepatic steatosis. In a multivariate adjustment model, as compared with participants without hepatic steatosis, those with moderate to severe steatosis had a hazard ratio (HR) of 3.24 (95% confidence interval [CI], 1.64 to 4.2) for the development of diabetes, and those in the mild steatosis group had a HR of 2.33 (95% CI, 1.42 to 3.80). One standard deviation decrease in mean CT attenuation values of the liver was associated with a 40% increase in the development of diabetes (multivariate adjusted HR, 1.40; 95% CI, 1.2 to 1.63).
Conclusion We found a positive association between severity of hepatic steatosis and risk of incident diabetes. Greater severity of steatosis was associated with a higher risk of incident diabetes.
- Miscellaneous
- Immune Checkpoint Inhibitors and Endocrine Disorders: A Position Statement from the Korean Endocrine Society
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Hyemi Kwon, Eun Roh, Chang Ho Ahn, Hee Kyung Kim, Cheol Ryong Ku, Kyong Yeun Jung, Ju Hee Lee, Eun Heui Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Jun Sung Moon, Jin Hwa Kim, Mi-kyung Kim, The Committee of Clinical Practice Guideline of the Korean Endocrine Society
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Endocrinol Metab. 2022;37(6):839-850. Published online December 26, 2022
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DOI: https://doi.org/10.3803/EnM.2022.1627
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- Immune checkpoint inhibitors (ICIs) including an anti-cytotoxic T-lymphocyte-associated antigen 4 inhibitor, anti-programmed cell death protein 1 (PD-1) inhibitors, and anti-PD-ligand 1 inhibitors are representative therapeutics for various malignancies. In oncology, the application of ICIs is currently expanding to a wider range of malignancies due to their remarkable clinical outcomes. ICIs target immune checkpoints which suppress the activity of T-cells that are specific for tumor antigens, thereby allowing tumor cells to escape the immune response. However, immune checkpoints also play a crucial role in preventing autoimmune reactions. Therefore, ICIs targeting immune checkpoints can trigger various immune-related adverse events (irAEs), especially in endocrine organs. Considering the endocrine organs that are frequently involved, irAEs associated endocrinopathies are frequently life-threatening and have unfavorable clinical implications for patients. However, there are very limited data from large clinical trials that would inform the development of clinical guidelines for patients with irAEs associated endocrinopathies. Considering the current clinical situation, in which the scope and scale of the application of ICIs are increasing, position statements from clinical specialists play an essential role in providing the appropriate recommendations based on both medical evidence and clinical experience. As endocrinologists, we would like to present precautions and recommendations for the management of immune-related endocrine disorders, especially those involving the adrenal, thyroid, and pituitary glands caused by ICIs.
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- Pembrolizumab plus lenvatinib for radically unresectable or metastatic renal cell carcinoma in the Japanese population
Ryo Fujiwara, Takeshi yuasa, kenichi kobayashi, tetsuya yoshida, susumu kageyama Expert Review of Anticancer Therapy.2023; 23(5): 461. CrossRef - Incidence of Endocrine-Related Dysfunction in Patients Treated with New Immune Checkpoint Inhibitors: A Meta-Analysis and Comprehensive Review
Won Sang Yoo, Eu Jeong Ku, Eun Kyung Lee, Hwa Young Ahn Endocrinology and Metabolism.2023; 38(6): 750. CrossRef
- Miscellaneous
- COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society
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Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim, the Committee of Clinical Practice Guideline of the Korean Endocrine Society
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Endocrinol Metab. 2021;36(4):757-765. Published online August 17, 2021
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DOI: https://doi.org/10.3803/EnM.2021.404
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- Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.
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- COVID-19 mRNA vaccine may trigger subacute thyroiditis
Mehmet Sözen, Ömercan Topaloğlu, Berrin Çetinarslan, Alev Selek, Zeynep Cantürk, Emre Gezer, Damla Köksalan, Taner Bayraktaroğlu Human Vaccines & Immunotherapeutics.2024; 17(12): 5120. CrossRef - The role of co-morbidities in the development of an AEFI after COVID-19 vaccination in a large prospective cohort with patient-reported outcomes in the Netherlands
C. Ouaddouh, J.W. Duijster, T. Lieber, F.P.A.M. van Hunsel Expert Opinion on Drug Safety.2024; 23(3): 323. CrossRef - Thyroid dysfunction in COVID-19
David Tak Wai Lui, Chi Ho Lee, Yu Cho Woo, Ivan Fan Ngai Hung, Karen Siu Ling Lam Nature Reviews Endocrinology.2024;[Epub] CrossRef - Adult-Onset Type 1 Diabetes Development Following COVID-19 mRNA Vaccination
Hyeyeon Moon, Sunghwan Suh, Mi Kyoung Park Journal of Korean Medical Science.2023;[Epub] CrossRef - Prior immunization status of COVID-19 patients and disease severity: A multicenter retrospective cohort study assessing the different types of immunity
Javaria Aslam, Faisal Shahzad Khan, Muhammad Talha Haris, Hewad Hewadmal, Maryam Khalid, Mohammad Y. Alshahrani, Qurrat-ul-ain Aslam, Irrum Aneela, Urooj Zafar Vaccine.2023; 41(2): 598. CrossRef - Mortality and Severity of Coronavirus Disease 2019 in Patients with Long-Term Glucocorticoid Therapy: A Korean Nationwide Cohort Study
Eu Jeong Ku, Keeho Song, Kyoung Min Kim, Gi Hyeon Seo, Soon Jib Yoo Endocrinology and Metabolism.2023; 38(2): 253. CrossRef - Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study
Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo Journal of Clinical Medicine.2023; 12(14): 4799. CrossRef - Inactivated SARS-CoV-2 vaccination does not disturb the clinical course of Graves’ disease: An observational cohort study
Shichen Xu, Huixin Yu, Xian Cheng, Jing Wu, Jiandong Bao, Li Zhang Vaccine.2023; 41(38): 5648. CrossRef - Adrenal Crisis Associated With COVID-19 Vaccination in Patients With Adrenal Insufficiency
Yukako Kurematsu, Takako Mohri, Sadanori Okada, Yutaka Takahashi JCEM Case Reports.2023;[Epub] CrossRef - Adverse Events Associated with COVID-19 Vaccination in Adolescents with Endocrinological Disorders: A Cross-Sectional Study
İbrahim Mert Erbaş, İrem Ceren Erbaş, Gözde Akın Kağızmanlı, Kübra Yüksek Acinikli, Özge Besci, Korcan Demir, Ece Böber, Nurşen Belet, Ayhan Abacı Journal of Clinical Research in Pediatric Endocrinology.2023; 15(3): 248. CrossRef - Neue Aspekte der Glukokortikoidsubstitution bei Nebennierenrindeninsuffizienz
Tina Kienitz, Gesine Meyer Der Internist.2022; 63(1): 12. CrossRef - Endocrine Follow-up During Post-Acute COVID-19: Practical Recommendations Based on Available Clinical Evidence
Rimesh Pal, Ameya Joshi, Sanjay K. Bhadada, Mainak Banerjee, Suresh Vaikkakara, Satinath Mukhopadhyay Endocrine Practice.2022; 28(4): 425. CrossRef - Safety of Inactivated and mRNA COVID-19 Vaccination Among Patients Treated for Hypothyroidism: A Population-Based Cohort Study
Xi Xiong, Carlos King Ho Wong, Ivan Chi Ho Au, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Celine Sze Ling Chui, Esther Wai Yin Chan, Franco Wing Tak Cheng, Kristy Tsz Kwan Lau, Chi Ho Lee, Yu Cho Woo, David Tak Wai Lui, Ian Chi Kei Wong Thyroid.2022; 32(5): 505. CrossRef - The New Entity of Subacute Thyroiditis amid the COVID-19 Pandemic: From Infection to Vaccine
Mihaela Popescu, Adina Ghemigian, Corina Maria Vasile, Andrei Costache, Mara Carsote, Alice Elena Ghenea Diagnostics.2022; 12(4): 960. CrossRef - Adrenal Crisis Secondary to COVID-19 Vaccination in a Patient With Hypopituitarism
Nikolina Markovic, Anila Faizan, Chirag Boradia, Sridhar Nambi AACE Clinical Case Reports.2022; 8(4): 171. CrossRef - The Effect of Inactivated SARS-CoV-2 Vaccines on TRAB in Graves’ Disease
LingHong Huang, ZhengRong Jiang, JingXiong Zhou, YuPing Chen, HuiBin Huang Frontiers in Endocrinology.2022;[Epub] CrossRef - Osteoporosis in Patients With Respiratory Diseases
Yue Ma, Shui Qiu, Renyi Zhou Frontiers in Physiology.2022;[Epub] CrossRef - Pilot Findings on SARS-CoV-2 Vaccine-Induced Pituitary Diseases: A Mini Review from Diagnosis to Pathophysiology
Ach Taieb, El Euch Mounira Vaccines.2022; 10(12): 2004. CrossRef - Forty Years Together, New Leap Forward! The 40th Anniversary of the Korean Endocrine Society
Jong Chul Won, Ki-Hyun Baek Endocrinology and Metabolism.2022; 37(6): 851. CrossRef - No need of glucocorticoid dose adjustment in patients with adrenal insufficiency before COVID-19 vaccine
Tania Pilli, Cristina Dalmiglio, Gilda Dalmazio, Alfonso Sagnella, Raffaella Forleo, Lucia Brilli, Fabio Maino, Cristina Ciuoli, Maria Grazia Castagna European Journal of Endocrinology.2022; 187(1): K7. CrossRef - Diabetes and COVID-19 Vaccination
Hae Dong Choi, Jun Sung Moon The Journal of Korean Diabetes.2021; 22(4): 221. CrossRef
- Clinical Study
- Development and Validation of a Risk Scoring System Derived from Meta-Analyses of Papillary Thyroid Cancer
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Sunghwan Suh, Tae Sik Goh, Yun Hak Kim, Sae-Ock Oh, Kyoungjune Pak, Ju Won Seok, In Joo Kim
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Endocrinol Metab. 2020;35(2):435-442. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.435
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Correction in: Endocrinol Metab 2023;38(2):287
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- Background
The aim of this study was to develop a scoring system to stratify the risk of papillary thyroid cancer (PTC) and to select the proper management.
Methods We performed a systematic search of MEDLINE and Embase. Data regarding patients’ prognoses were obtained from the included studies. Odds ratios (ORs) with statistical significance were extracted from the publications. To generate a risk scoring system (RSS), ORs were summed (RSS1), and summed after natural-logarithmic transformation (RSS2). RSS1 and RSS2 were compared to the eighth edition of the American Joint Committee on Cancer (AJCC) staging system and the 2015 American Thyroid Association (ATA) guidelines for thyroid nodules and differentiated thyroid carcinoma.
Results Five meta-analyses were eligible for inclusion in the study. Eight variables (sex, tumour size, extrathyroidal extension, BRAF mutation, TERT mutation, histologic subtype, lymph node metastasis, and distant metastasis) were included. RSS1 was the best of the analysed models.
Conclusion We developed and validated a new RSS derived from previous meta-analyses for patients with PTC. This RSS seems to be superior to previously published systems.
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- Investigating 18F-FDG PET/CT Parameters as Prognostic Markers for Differentiated Thyroid Cancer: A Systematic Review
Hongxi Wang, Hongyuan Dai, Qianrui Li, Guohua Shen, Lei Shi, Rong Tian Frontiers in Oncology.2021;[Epub] CrossRef - Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
Joohyun Woo, Hyeonkyeong Kim, Hyungju Kwon Journal of Clinical Medicine.2021; 10(21): 5144. CrossRef
- Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem
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Sunghwan Suh, Mi Kyoung Park
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Endocrinol Metab. 2017;32(2):180-189. Published online May 29, 2017
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DOI: https://doi.org/10.3803/EnM.2017.32.2.180
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Glucocorticoids are widely used as potent anti-inflammatory and immunosuppressive drugs to treat a wide range of diseases. However, they are also associated with a number of side effects, including new-onset hyperglycemia in patients without a history of diabetes mellitus (DM) or severely uncontrolled hyperglycemia in patients with known DM. Glucocorticoid-induced diabetes mellitus (GIDM) is a common and potentially harmful problem in clinical practice, affecting almost all medical specialties, but is often difficult to detect in clinical settings. However, scientific evidence is lacking regarding the effects of GIDM, as well as strategies for prevention and treatment. Similarly to nonsteroid-related DM, the principles of early detection and risk factor modification apply. Screening for GIDM should be considered in all patients treated with medium to high doses of glucocorticoids. Challenges in the management of GIDM stem from wide fluctuations in postprandial hyperglycemia and the lack of clearly defined treatment protocols. Together with lifestyle measures, hypoglycemic drugs with insulin-sensitizing effects are indicated. However, insulin therapy is often unavoidable, to the point that insulin can be considered the drug of choice. The treatment of GIDM should take into account the degree and pattern of hyperglycemia, as well as the type, dose, and schedule of glucocorticoid used. Moreover, it is essential to instruct the patient and/or the patient's family about how to perform the necessary adjustments. Prospective studies are needed to answer the remaining questions regarding GIDM.
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- Clinical Study
- Glucose-Dependent Insulinotropic Peptide Level Is Associated with the Development of Type 2 Diabetes Mellitus
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Sunghwan Suh, Mi Yeon Kim, Soo Kyoung Kim, Kyu Yeon Hur, Mi Kyoung Park, Duk Kyu Kim, Nam H. Cho, Moon-Kyu Lee
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Endocrinol Metab. 2016;31(1):134-141. Published online March 16, 2016
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DOI: https://doi.org/10.3803/EnM.2016.31.1.134
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- Background
Incretin hormone levels as a predictor of type 2 diabetes mellitus have not been fully investigated. Therefore, we measured incretin hormone levels to examine the relationship between circulating incretin hormones, diabetes, and future diabetes development in this study. MethodsA nested case-control study was conducted in a Korean cohort. The study included the following two groups: the control group (n=149), the incident diabetes group (n=65). Fasting total glucagon-like peptide-1 (GLP-1) and total glucose-dependent insulinotropic peptide (GIP) levels were measured and compared between these groups. ResultsFasting total GIP levels were higher in the incident diabetes group than in the control group (32.64±22.68 pmol/L vs. 25.54±18.37 pmol/L, P=0.034). There was no statistically significant difference in fasting total GLP-1 levels between groups (1.14±1.43 pmol/L vs. 1.39±2.13 pmol/L, P=0.199). In multivariate analysis, fasting total GIP levels were associated with an increased risk of diabetes (odds ratio, 1.005; P=0.012) independent of other risk factors. ConclusionFasting total GIP levels may be a risk factor for the development of type 2 diabetes mellitus. This association persisted even after adjusting for other metabolic parameters such as elevated fasting glucose, hemoglobin A1c, and obesity in the pre-diabetic period.
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Karlijn A. C. Meeks, Amy R. Bentley, Themistocles L. Assimes, Nora Franceschini, Adebowale A. Adeyemo, Charles N. Rotimi, Ayo P. Doumatey Genome Medicine.2023;[Epub] CrossRef - Glucose- and Bile Acid-Stimulated Secretion of Gut Hormones in the Isolated Perfused Intestine Is Not Impaired in Diet-Induced Obese Mice
Jenna E. Hunt, Jens J. Holst, Sara L. Jepsen Frontiers in Endocrinology.2022;[Epub] CrossRef - Combined treatment with a gastric inhibitory polypeptide receptor antagonist and a peptidyl peptidase-4 inhibitor improves metabolic abnormalities in diabetic mice
Fei Yang, Shan Dang, Hongjun LV, Bingyin Shi Journal of International Medical Research.2021; 49(1): 030006052098566. CrossRef - Elevated levels of fasting serum GIP may be protective factors for diabetic retinopathy in type 2 diabetes mellitus
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Tina Jorsal, Nicolai A. Rhee, Jens Pedersen, Camilla D. Wahlgren, Brynjulf Mortensen, Sara L. Jepsen, Jacob Jelsing, Louise S. Dalbøge, Peter Vilmann, Hazem Hassan, Jakob W. Hendel, Steen S. Poulsen, Jens J. Holst, Tina Vilsbøll, Filip K. Knop Diabetologia.2018; 61(2): 284. CrossRef - Articles inEndocrinology and Metabolismin 2016
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- Thyroid
- Subclinical Hypothyroidism and Cardiovascular Disease
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Sunghwan Suh, Duk Kyu Kim
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Endocrinol Metab. 2015;30(3):246-251. Published online August 4, 2015
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DOI: https://doi.org/10.3803/EnM.2015.30.3.246
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Subclinical hypothyroidism (SCH) is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. Thyroid hormones are known to affect the heart and vasculature and, as a result, the impact of SCH on the cardiovascular (CV) system has recently become an important topic of research. Strong evidence points to a link between SCH and CV risk factors such as alterations in blood pressure, lipid levels, and atherosclerosis. Additionally, accumulating evidence indicates that SCH is associated with metabolic syndrome and heart failure. The present review proposes that SCH may be a potentially modifiable risk factor of CV disease and mortality. However, large-scale clinical trials with appropriate power investigating the risks and benefits of SCH treatment are required to determine whether these benefits can be achieved with levothyroxine therapy.
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Anthi Vasilopoulou, Vasiliki Patsiou, Alexandra Bekiaridou, Andreas S. Papazoglou, Dimitrios V. Moysidis, Marina Spaho, Martha Zergioti, Dimitrios Kostakakis, Maria-Eirini Kyriakideli, Chrysanthi-Ioanna Lampropoulou, Anastasios Kartas, Athanasios Samaras, Heart and Vessels.2024; 39(2): 185. CrossRef - A Comparative Study of Iron Status in Subclinical Hypothyroid and Euthyroid Subjects in a Tertiary Care Hospital
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Rohit Vasant Deshpande, Swati Harish Sharma, Swapnil Sahebrao Walke, Mayur Ramakrishnarao Hedau, Bharat Sing Rathod, Amol Raghunath Bhore, Hitesh Lotan Mahale Journal of Evolution of Medical and Dental Sciences.2017; 6(45): 3514. CrossRef - The Association of Thyroid Hormones and Tsh with the Metabolic Syndrome in Euthyroid Taiwanese Individuals
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Yasemin Isik-Balci, Sebahat Agladioglu, Kadir Agladioglu, Emine Kilic-Toprak, Ozgen Kilic-Erkek, Bayram Ozhan, Aziz Polat, Melek Bor-Kucukatay Hormone Research in Paediatrics.2016; 85(4): 250. CrossRef
- Obesity and Metabolism
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Sunghwan Suh
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Endocrinol Metab. 2015;30(1):45-46. Published online March 27, 2015
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DOI: https://doi.org/10.3803/EnM.2015.30.1.45
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- Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis
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Sun Mi Park, Ji Cheol Bae, Ji Young Joung, Yoon Young Cho, Tae Hun Kim, Sang-Man Jin, Sunghwan Suh, Kyu Yeon Hur, Kwang-Won Kim
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Endocrinol Metab. 2014;29(4):470-478. Published online December 29, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.4.470
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Abstract
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- Background
Primary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established. MethodsMedical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were retrospectively reviewed. Based on the anatomical location, we classified the cases as adenohypophysitis (AH), infundibuloneurohypophysitis (INH), and panhypophysitis (PH). Clinical presentation, endocrine function, pathologic findings, magnetic resonance imaging findings, and treatment courses were reviewed. ResultsAmong 22 patients with primary hypophysitis, 81.8% (18/22) had involvement of the posterior pituitary lobe. Two patients of the AH (2/3, 66.6%) and three patients of the PH (3/10, 30%) groups initially underwent surgical mass reduction. Five patients, including three of the PH (3/10, 33.3%) group and one from each of the AH (1/3, 33.3%) and INH (1/9, 11.1%) groups, initially received high-dose glucocorticoid treatment. Nearly all of the patients treated with surgery or high-dose steroid treatment (9/11, 82%) required continuous hormone replacement during the follow-up period. Twelve patients received no treatment for mass reduction due to the absence of acute symptoms and signs related to a compressive mass effect. Most of them (11/12, 92%) did not show disease progression, and three patients recovered partially from hormone deficiency. ConclusionDeficits of the posterior pituitary were the most common features in our cases of primary hypophysitis. Pituitary endocrine defects responded less favorably to glucocorticoid treatment and surgery. In the absence of symptoms related to mass effect and with the mild defect of endocrine function, it may not require treatment to reduce mass except hormone replacement.
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Salma Salhi, Ibtissem Oueslati, Yasmine Mouelhi, Alia Zehani, Nidhameddine Kchir, Elyes Kamoun, Meriem Yazidi, Melika Chihaoui Journal of International Medical Research.2024;[Epub] CrossRef - Glucocorticoid therapy as first-line treatment in primary hypophysitis: a systematic review and individual patient data meta-analysis
Brijesh Krishnappa, Ravikumar Shah, Saba Samad Memon, Chakra Diwaker, Anurag R Lila, Virendra A Patil, Nalini S Shah, Tushar R Bandgar Endocrine Connections.2023;[Epub] CrossRef - Hypophysitis, the Growing Spectrum of a Rare Pituitary Disease
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Diane Donegan, Zeb Saeed, Danae A Delivanis, Mohammad Hassan Murad, Juergen Honegger, Felix Amereller, Seda Hanife Oguz, Dana Erickson, Irina Bancos The Journal of Clinical Endocrinology & Metabolism.2022; 107(4): 1170. CrossRef - Early Pulse Glucocorticoid Therapy and Improved Hormonal Outcomes in Primary Hypophysitis
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Marouan Karrou, Salma Benyakhlef, Achwak Alla, Najoua Messaoudi, Asmae Oulad Amar, Siham Rouf, Imane Kamaoui, Noureddine Oulali, Faycal Moufid, Naima Abda, Hanane Latrech Surgical Neurology International.2021; 12: 304. CrossRef - Clinical aspects of autoimmune hypothalamitis, a variant of autoimmune hypophysitis: Experience from one center
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Anna Angelousi, Krystallenia Alexandraki, Marina Tsoli, Gregory Kaltsas, Eva Kassi Neuroendocrinology.2020; 110(9-10): 822. CrossRef - Hypophysitis in the era of immune checkpoint inhibitors and immunoglobulin G4-related disease
Leen Wehbeh, Sama Alreddawi, Roberto Salvatori Expert Review of Endocrinology & Metabolism.2019; 14(3): 167. CrossRef - Immune check point inhibitors-induced hypophysitis: a retrospective analysis of the French Pharmacovigilance database
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Sriram Gubbi, Fady Hannah-Shmouni, Constantine A. Stratakis, Christian A. Koch Reviews in Endocrine and Metabolic Disorders.2018; 19(4): 335. CrossRef - Primary lymphocytic hypophysitis: Clinical characteristics and treatment of 50 cases in a single centre in China over 18 years
Shuchang Wang, Linjie Wang, Yong Yao, Feng Feng, Hongbo Yang, Zhiyong Liang, Kan Deng, Hui You, Jian Sun, Bing Xing, Zimeng Jin, Renzhi Wang, Hui Pan, Huijuan Zhu Clinical Endocrinology.2017; 87(2): 177. CrossRef - Clinical presentation and outcome of children with central diabetes insipidus associated with a self‐limited or transient pituitary stalk thickening, diagnosed as infundibuloneurohypophysitis
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Georgios F. Hadjigeorgiou, Eva Løbner Lund, Lars Poulsgaard, Ulla Feldt-Rasmussen, Åse Krogh Rasmussen, Marianne Wegener, Kåre Fugleholm Acta Neurochirurgica.2017; 159(11): 2229. CrossRef - Granulomatous and lymphocytic hypophysitis – are they immunologically distinct?
Shilpa Rao, Anita Mahadevan, Tanmoy Maiti, Manish Ranjan, Shivayogi Durgad Shwetha, Arimappamagan Arivazhagan, Jitender Saini APMIS.2016; 124(12): 1072. CrossRef - Articles in 'Endocrinology and Metabolism' in 2014
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- Sex Factors in the Metabolic Syndrome as a Predictor of Cardiovascular Disease
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Sunghwan Suh, Jongha Baek, Ji Cheol Bae, Kyoung-Nyoun Kim, Mi Kyoung Park, Duk Kyu Kim, Nam H. Cho, Moon-Kyu Lee
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Endocrinol Metab. 2014;29(4):522-529. Published online December 29, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.4.522
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- Background
Metabolic syndrome (MetS) is a condition characterized by a cluster of metabolic disorders and is associated with increased risk of cardiovascular disease (CVD). This study analyzed data from the Korean Health and Genome Study to examine the impact of MetS on CVD. MethodsA total of 8,898 subjects (4,241 males and 4,657 females), 40 to 69 years of age, were enrolled and evaluated for the development of new onset CVD from 2001 to 2012 (median 8.1 years of follow-up). ResultsThe prevalence of MetS at baseline was 22.0% (932/4,241) and 29.7% (1,383/4,657) in males and females, respectively. MetS was associated with increased risk of coronary heart disease (CHD; hazard ratio [HR], 1.818; 95% confidence interval [CI], 1.312 to 2.520 in males; HR, 1.789; 95% CI, 1.332 to 2.404 in females) and CVD (HR, 1.689; 95% CI, 1.295 to 2.204 in males; HR, 1.686; 95% CI, 1.007 to 2.192 in females). Specifically, MetS was associated with risk of future stroke in females only (HR, 1.486; 95% CI, 1.007 to 2.192). Among MetS components, abdominal obesity and hypertension were independent predictors of both CHD and CVD. In addition, a higher number of MetS components correlated with higher CVD risk. ConclusionMetS is a significant risk factor for the development of CVD although its impact varies between sexes.
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