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Intraoperative Parathyroid Hormone Monitoring in the Surgical Management of Sporadic Primary Hyperparathyroidism
Zahra F. Khan, John I. Lew
Endocrinol Metab. 2019;34(4):327-339.   Published online December 23, 2019
DOI: https://doi.org/10.3803/EnM.2019.34.4.327
  • 5,238 View
  • 115 Download
  • 22 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   ePub   

Intraoperative parathyroid hormone monitoring (IPM) has been shown to be a useful adjunct during parathyroidectomy to ensure operative success at many specialized medical centers worldwide. Using the Miami or “>50% intraoperative PTH drop” criterion, IPM confirms the complete excision of all hyperfunctioning parathyroid tissue before the operation is finished, and helps guide the surgeon to identify additional hyperfunctioning parathyroid glands that may necessitate further extensive neck exploration when intraoperative parathyroid hormone (PTH) levels do not drop sufficiently. The intraoperative PTH assay is also used to differentiate parathyroid from non-parathyroid tissues during operations using fine needle aspiration samples and to lateralize the side of the neck harboring the hypersecreting parathyroid through differential jugular venous sampling when preoperative localization studies are negative or equivocal. The use of IPM underscores the recognition and understanding of sporadic primary hyperparathyroidism (SPHPT) as a disease of function rather than form, where the surgeon is better equipped to treat such patients with quantitative instead of qualitative information for durable long-term operative success. There has been a significant paradigm shift over the last 2 decades from conventional to focused parathyroidectomy guided by IPM. This approach has proven to be a safe and rapid operation requiring minimal dissection performed in an ambulatory setting for the treatment of SPHPT.

Citations

Citations to this article as recorded by  
  • Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy
    Phillip Staibano, Kevin Um, Sheila Yu, Mohit Bhandari, Michael K. Gupta, Michael Au, JEM (Ted) Young, Han Zhang
    Frontiers in Surgery.2024;[Epub]     CrossRef
  • Parathyroidectomy for primary hyperparathyroidism: A retrospective analysis of localization, surgical characteristics, and treatment outcomes
    Dongbin Ahn, Ji Hye Kwak, Gil Joon Lee, Jin Ho Sohn
    Asian Journal of Surgery.2023; 46(2): 788.     CrossRef
  • Magnitude of parathyroid hormone elevation in primary hyperparathyroidism: Does time of day matter?
    C. Corbin Frye, Janessa Sullivan, Sai Anusha Sanka, Jingxia Liu, L. Michael Brunt, William Gillanders, Taylor C. Brown, T.K. Pandian
    Surgery.2023; 173(3): 659.     CrossRef
  • Analysis of intraoperative laboratory measurements and imaging techniques such as Tc-99 m-MIBI SPECT/CT, 18F-fluorocholine PET/CT and ultrasound in patients operated with prediagnosis of parathyroid adenoma
    Nurullah Bilen, Mehmet Avni Gokalp, Latif Yilmaz, Alper Aytekin, Ilyas Baskonus
    Irish Journal of Medical Science (1971 -).2023; 192(4): 1695.     CrossRef
  • Intraoperative Parathyroid Hormone Monitoring Is of Limited Usefulness in Guiding Autotransplantation in Reoperative or Subtotal Parathyroidectomy for Primary Hyperparathyroidism
    Bradley A. Richards, Robert A. Vierkant, Benzon M. Dy, Trenton R. Foster, Travis J. McKenzie, Melanie L. Lyden
    The American Surgeon™.2023; 89(12): 5421.     CrossRef
  • Does 18F-Fluorocholine PET/CT add value to positive parathyroid scintigraphy in the presurgical assessment of primary hyperparathyroidism?
    Alessio Imperiale, Jacob Bani, Gianluca Bottoni, Adrien Latgé, Céline Heimburger, Ugo Catrambone, Michel Vix, Giorgio Treglia, Arnoldo Piccardo
    Frontiers in Medicine.2023;[Epub]     CrossRef
  • Intraoperative Identification of Thyroid and Parathyroid Tissues During Human Endocrine Surgery Using the MasSpec Pen
    Rachel J. DeHoog, Mary E. King, Michael F. Keating, Jialing Zhang, Marta Sans, Clara L. Feider, Kyana Y. Garza, Alena Bensussan, Anna Krieger, John Q. Lin, Sunil Badal, Elizabeth Alore, Christopher Pirko, Kirtan Brahmbhatt, Wendong Yu, Raymon Grogan, Livi
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  • A Rare Case of Recurrent Parathyroid Adenomas After Initial Parathyroidectomy
    Grant N Schalet, Luke Vincent, Carl Eguez, Gerardo Diaz, Mark S Shachner
    Cureus.2023;[Epub]     CrossRef
  • Surgical treatment of tertiary hyperparathyroidism: does one fit for all?
    Claudio Casella, Claudio Guarneri, Manuela Campanile, Xavier Adhoute, Pier Paolo Gelera, Riccardo Morandi
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • A >50% Intraoperative Parathyroid Hormone Decrease Into Normal Reference Range Predicts Complete Excision of Malignancy in Patients With Parathyroid Carcinoma
    Valerie L. Armstrong, Tanaz M. Vaghaiwalla, Cima Saghira, Cheng-Bang Chen, Yujie Wang, Johan Anantharaj, Mehmet Ackin, John I. Lew
    Journal of Surgical Research.2023;[Epub]     CrossRef
  • Variation in parathyroid adenoma size in patients with sporadic, primary hyperparathyroidism: small gland size does not preclude single gland disease
    Sophie Dream, Tina W. F. Yen, Kara Doffek, Douglas B. Evans, Tracy S. Wang
    Langenbeck's Archives of Surgery.2022; 407(5): 2067.     CrossRef
  • Role and Recent Trend of Intraoperative Parathyroid Hormone Monitoring During Parathyroidectomy in Patients With Primary Hyperparathyroidism
    Dongbin Ahn, Ji Hye Kwak
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2022; 65(5): 253.     CrossRef
  • Parathyroid Adenoma: Rare Cause of Acute Recurrent Pancreatitis
    Shikha Mahajan, Alka Kumar, Vivek Aggarwal, Vikas Jain, Vipul Baweja, Ajay Ajmani, Diplomate CBNC, Fellow EBNM LNU
    Annals of Pediatric Gastroenterology and Hepatology.2022; 2(3-4): 9.     CrossRef
  • Long-term outcome of surgical techniques for sporadic primary hyperparathyroidism in a tertiary referral center in Belgium
    Klaas Van Den Heede, Amélie Bonheure, Nele Brusselaers, Sam Van Slycke
    Langenbeck's Archives of Surgery.2022; 407(7): 3045.     CrossRef
  • Contribution of intraoperative parathyroid hormone monitoring to the surgical success in minimal invasive parathyroidectomy
    Ismail Ethem Akgün, Mehmet Taner Ünlü, Nurcihan Aygun, Mehmet Kostek, Mehmet Uludag
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • Surgery for primary hyperparathyroidism
    Murilo Catafesta das Neves, Rodrigo Oliveira Santos, Monique Nakayama Ohe
    Archives of Endocrinology and Metabolism.2022; 66(5): 678.     CrossRef
  • Використання інтраопераційного моніторингу рівня паратиреоїдного гормону в мінімально інвазивній хірургії щитоподібної та паращитоподібних залоз
    S.V. Chernyshov, A.V. Tymkiv, A.V. Vovkanych, I.I. Komisarenko
    Endokrynologia.2022; 27(4): 311.     CrossRef
  • Diagnostic Values of Intraoperative (1-84) Parathyroid Hormone Levels are Superior to Intact Parathyroid Hormone for Successful Parathyroidectomy in Patients With Chronic Kidney Disease
    Fangyan Xu, Yaoyu Huang, Ming Zeng, Lina Zhang, Wenkai Ren, Hanyang Qian, Ying Cui, Guang Yang, Wenbin Zhou, Shui Wang, Hui Huang, Huimin Chen, Yujie Xiao, Xueyan Gao, Zhanhui Gao, Jing Wang, Cuiping Liu, Jing Zhang, Baiqiao Zhao, Anning Bian, Fan Li, Hui
    Endocrine Practice.2021; 27(11): 1065.     CrossRef
  • Delayed Calcium Normalization after Successful Parathyroidectomy in Primary Hyperparathyroidism
    Iván Emilio de la Cruz Rodríguez, Elsy Sarahí García Montesinos, María Fernanda Rodríguez-Delgado, Guadalupe Vargas Ortega, Lourdes Balcázar Hernández, Victoria Mendoza Zubieta, Victor Hernández Avendaño, Baldomero González Virla, Micha�l R. Laurent
    Case Reports in Endocrinology.2021; 2021: 1.     CrossRef
  • Parathyroid Surgery
    Aditya S. Shirali, Uriel Clemente-Gutierrez, Nancy D. Perrier
    Neuroimaging Clinics of North America.2021; 31(3): 397.     CrossRef
  • Focused parathyroidectomy without intraoperative parathyroid hormone measurement in primary hyperparathyroidism: Still a valid approach?
    Shelby Holt
    Surgery.2021; 170(6): 1860.     CrossRef
  • Response to the Comment on “Risk Factors of Redo Surgery After Unilateral Focused Parathyroidectomy – Conclusions From a Comprehensive Nationwide Database of 13,247 Interventions Over 6 Years”
    Robert Caiazzo, Camille Marciniak, Francois Pattou
    Annals of Surgery.2021; 274(6): e861.     CrossRef
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Bone Metabolism
Recent Topics in Fibrodysplasia Ossificans Progressiva
Takenobu Katagiri, Sho Tsukamoto, Yutaka Nakachi, Mai Kuratani
Endocrinol Metab. 2018;33(3):331-338.   Published online September 18, 2018
DOI: https://doi.org/10.3803/EnM.2018.33.3.331
  • 4,838 View
  • 77 Download
  • 19 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   ePub   

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disease that is characterized by the formation of heterotopic bone tissues in soft tissues, such as skeletal muscle, ligament, and tendon. It is difficult to remove such heterotopic bones via internal medicine or invasive procedures. The identification of activin A receptor, type I (ACVR1)/ALK2 gene mutations associated with FOP has allowed the genetic diagnosis of FOP. The ACVR1/ALK2 gene encodes the ALK2 protein, which is a transmembrane kinase receptor in the transforming growth factor-β family. The relevant mutations activate intracellular signaling in vitro and induce heterotopic bone formation in vivo. Activin A is a potential ligand that activates mutant ALK2 but not wild-type ALK2. Various types of small chemical and biological inhibitors of ALK2 signaling have been developed to establish treatments for FOP. Some of these are in clinical trials in patients with FOP.

Citations

Citations to this article as recorded by  
  • How Activin A Became a Therapeutic Target in Fibrodysplasia Ossificans Progressiva
    Dushyanth Srinivasan, Martin Arostegui, Erich J. Goebel, Kaitlin N. Hart, Senem Aykul, John B. Lees-Shepard, Vincent Idone, Sarah J. Hatsell, Aris N. Economides
    Biomolecules.2024; 14(1): 101.     CrossRef
  • Fibrodysplasia Ossificans Progressiva Mimics Generalized Dystonia Disorder: A Case Report
    Seraj Makkawi, Osama Khojah, Reema Abualnaja, Abdulaziz Qashqari, Nawaf A Alahmadi, Abdullatif G Bshnaq, Abdulrahman Alharthi, Hashem H Al-Hashemi, Aiman M Shawli
    Cureus.2023;[Epub]     CrossRef
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    Hiroyuki Yamazaki
    Journal of Natural Medicines.2022; 76(1): 1.     CrossRef
  • A Novel De Novo Frameshift Pathogenic Variant in the FAM111B Resulting in Progressive Osseous Heteroplasia Phenotype
    Anna Ryabets-Lienhard, Panadeekarn Panjawatanan, Kyle Vogt, Jianling Ji, Senta Georgia, Pisit Pitukcheewanont
    Calcified Tissue International.2022; 112(4): 518.     CrossRef
  • Inhibitory effects of sesquiterpene lactones from the Indonesian marine sponge Lamellodysidea cf. herbacea on bone morphogenetic protein-induced osteoblastic differentiation
    Satoshi Ohte, Hiroyuki Yamazaki, Ohgi Takahashi, Henki Rotinsulu, Defny S. Wewengkang, Deiske A. Sumilat, Delfly B. Abdjul, Wilmar Maarisit, Magie M. Kapojos, Huiping Zhang, Fumiaki Hayashi, Michio Namikoshi, Takenobu Katagiri, Hiroshi Tomoda, Ryuji Uchid
    Bioorganic & Medicinal Chemistry Letters.2021; 35: 127783.     CrossRef
  • Genomic Context and Mechanisms of the ACVR1 Mutation in Fibrodysplasia Ossificans Progressiva
    Roberto Ravazzolo, Renata Bocciardi
    Biomedicines.2021; 9(2): 154.     CrossRef
  • New insights on fibrodysplasia ossificans progressiva: discussion of an autoptic case report and brief literature review
    Vittorio Bolcato, Claudia Carelli, Silvia Damiana Visonà, Marcella Reguzzoni, Maja Di Rocco, Alessandra Radogna, Livio Pietro Tronconi, Matteo Moretti
    Intractable & Rare Diseases Research.2021; 10(2): 136.     CrossRef
  • Accumulated Knowledge of Activin Receptor-Like Kinase 2 (ALK2)/Activin A Receptor, Type 1 (ACVR1) as a Target for Human Disorders
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    Biomedicines.2021; 9(7): 736.     CrossRef
  • Cytoskeleton Reorganization in EndMT—The Role in Cancer and Fibrotic Diseases
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    International Journal of Molecular Sciences.2021; 22(21): 11607.     CrossRef
  • Alendronate disturbs femoral growth due to changes during immunolocalization of transforming growth factor-β1 and bone morphogenetic protein-2 in epiphyseal plate
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    World Journal of Experimental Medicine.2020; 10(1): 1.     CrossRef
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    Katsuhiko Sekimata, Tomohiro Sato, Naoki Sakai
    Chemical and Pharmaceutical Bulletin.2020; 68(3): 194.     CrossRef
  • Role of Signal Transduction Pathways and Transcription Factors in Cartilage and Joint Diseases
    Riko Nishimura, Kenji Hata, Yoshifumi Takahata, Tomohiko Murakami, Eriko Nakamura, Maki Ohkawa, Lerdluck Ruengsinpinya
    International Journal of Molecular Sciences.2020; 21(4): 1340.     CrossRef
  • Design of primers for direct sequencing of nine coding exons in the human ACVR1 gene
    Masaru Matsuoka, Sho Tsukamoto, Yuta Orihara, Rieko Kawamura, Mai Kuratani, Nobuhiko Haga, Kenji Ikebuchi, Takenobu Katagiri
    Bone.2020; 138: 115469.     CrossRef
  • A new diketopiperazine-like inhibitor of bone morphogenetic protein-induced osteoblastic differentiation produced by marine-derived Aspergillus sp. BFM-0085
    Satoshi Ohte, Takehiro Shiokawa, Nobuhiro Koyama, Takenobu Katagiri, Chiaki Imada, Hiroshi Tomoda
    The Journal of Antibiotics.2020; 73(8): 554.     CrossRef
  • Penicillic Acid Congener, a New Inhibitor of BMP-Induced Alkaline Phosphatase Activity in Myoblasts, Produced by the Fungus Penicillium sp. BF-0343
    Nobuhiro Koyama, Yasuhiro Otoguro, Satoshi Ohte, Takenobu Katagiri, Hiroshi Tomoda
    Natural Product Communications.2020; 15(9): 1934578X2094265.     CrossRef
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    Arun-Kumar Kaliya-Perumal, Tom J. Carney, Philip W. Ingham
    Disease Models & Mechanisms.2020;[Epub]     CrossRef
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    Biomedicines.2020; 8(9): 325.     CrossRef
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    Hiroyuki Yamazaki, Satoshi Ohte, Henki Rotinsulu, Defny S. Wewengkang, Deiske A. Sumilat, Delfly B. Abdjul, Wilmar Maarisit, Magie M. Kapojos, Michio Namikoshi, Takenobu Katagiri, Hiroshi Tomoda, Ryuji Uchida
    Marine Drugs.2020; 18(12): 606.     CrossRef
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    Durval Batista Palhares, Deborah Ribeiro Nascimento, Marilene Garcia Palhares, Suzana Lopes Bomfim Balaniuc, Liane de Rosso Giuliani, Paula Cristhina Niz Xavier, José Mauro Goulart Brum, Fabiana Alves, Francisco Oliveira Vieira, Elaine Maria Souza-Fagunde
    Intractable & Rare Diseases Research.2019; 8(1): 24.     CrossRef
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  • Discovery of Heterotopic Bone-Inducing Activity in Hard Tissues and the TGF-β Superfamily
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Original Articles
Clinical Study
Effects of Short-Term Exenatide Treatment on Regional Fat Distribution, Glycated Hemoglobin Levels, and Aortic Pulse Wave Velocity of Obese Type 2 Diabetes Mellitus Patients
Ju-Young Hong, Keun-Young Park, Byung-Joon Kim, Won-Min Hwang, Dong-Ho Kim, Dong-Mee Lim
Endocrinol Metab. 2016;31(1):80-85.   Published online March 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.1.80
  • 4,791 View
  • 44 Download
  • 26 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   
Background

Most type 2 diabetes mellitus patients are obese and have obesity related vascular complications. Exenatide treatment is well known for both decreasing glycated hemoglobin levels and reduction in body weight. So, this study aimed to determine the effects of exenatide on body composition, glycated hemoglobin levels, and vascular stiffness in obese type 2 diabetes mellitus patients.

Methods

For 1 month, 32 obese type 2 diabetes mellitus patients were administered 5 µg of exenatide twice daily. The dosage was then increased to 10 µg. Patients' height, body weight, glycated hemoglobin levels, lipid profile, pulse wave velocity (PWV), body mass index, fat mass, and muscle mass were measured by using Inbody at baseline and after 3 months of treatment.

Results

After 3 months of treatment, glycated hemoglobin levels decreased significantly (P=0.007). Triglyceride, total cholesterol, and low density lipoprotein levels decreased, while aspartate aminotransferase and alanine aminotransferase levels were no change. Body weight, and fat mass decreased significantly (P=0.002 and P=0.001, respectively), while interestingly, muscle mass did not decrease (P=0.289). In addition to, Waist-to-hip ratio and aortic PWV decreased significantly (P=0.006 and P=0.001, respectively).

Conclusion

Effects of short term exenatide use in obese type 2 diabetes mellitus with cardiometabolic high risk patients not only reduced body weight without muscle mass loss, body fat mass, and glycated hemoglobin levels but also improved aortic PWV in accordance with waist to hip ratio.

Citations

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    Liv Vernstrøm, Søren Gullaksen, Steffen S. Sørensen, Kristian L. Funck, Esben Laugesen, Per L. Poulsen
    Diabetes, Obesity and Metabolism.2024;[Epub]     CrossRef
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    Daniel de Luis Román, Juana Carretero Gómez, José Manuel García-Almeida, Fernando Garrachón Vallo, German Guzmán Rolo, Juan José López Gómez, Francisco José Tarazona-Santabalbina, Alejandro Sanz-Paris
    Reviews in Endocrine and Metabolic Disorders.2024;[Epub]     CrossRef
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    Qiuhe Ji
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Obesity and Metabolism
Correlation between Expression of Glucose Transporters in Granulosa Cells and Oocyte Quality in Women with Polycystic Ovary Syndrome
Eunju Kim, Hyun Ha Seok, Su-Yeon Lee, Dong Ryul Lee, Jisook Moon, Tae Ki Yoon, Woo Sik Lee, Kyung-Ah Lee
Endocrinol Metab. 2014;29(1):40-47.   Published online March 14, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.1.40
  • 4,517 View
  • 53 Download
  • 22 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   
Background

The glucose transporters (GLUTs) exhibit different tissue-specific expression. This study aimed to investigate the types of GLUTs expressed in human granulosa cells (GCs) obtained from women with polycystic ovary syndrome (PCOS) and their relationship with insulin resistance (IR) and the outcomes of in vitro maturation (IVM) of immature oocytes.

Methods

Expression of GLUTs was evaluated in GCs from women with PCOS with or without IR. Thirty-six women with PCOS undergoing an IVM program were included. Differential gene expression between the insulin sensitive (IS) and IR group was measured by reverse transcription polymerase chain reaction.

Results

Expression of GLUTs 1, 3, 5, 8, and 13 was constitutive, whereas expression of GLUTs 2 and 7 was not observed in human GCs. The remaining GLUTs, 4, 6, 9, 10, 11, and 12, were differentially expressed among patients according to metabolic status, such as insulin sensitivity. A higher number of GCs from patients with IR (92%) expressed GLUT6 than GCs from IS PCOS patients (46.3%). Logistic regression showed that expression of GLUTs 9, 11, and 12 correlates with rates of IVM at 48 hours, fertilization, and implantation, respectively.

Conclusion

This is the first report describing the expression pattern of all 13 members of the GLUT family in human GCs. Results of the present study suggest that patients' insulin sensitivity regulates GLUT expression in GCs in PCOS patients, and this may control oocyte quality for IVM and subsequent processes such as fertilization and implantation in patients taking part in an in vitro fertilization program.

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Close layer
Review Article
Bone Metabolism
Growth and Age-Related Abnormalities in Cortical Structure and Fracture Risk
Ego Seeman
Endocrinol Metab. 2015;30(4):419-428.   Published online December 31, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.4.419
  • 4,210 View
  • 62 Download
  • 23 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   

Vertebral fractures and trabecular bone loss have dominated thinking and research into the pathogenesis and the structural basis of bone fragility during the last 70 years. However, 80% of all fractures are non-vertebral and occur at regions assembled using large amounts of cortical bone; only 20% of fractures are vertebral. Moreover, ~80% of the skeleton is cortical and ~70% of all bone loss is cortical even though trabecular bone is lost more rapidly than cortical bone. Bone is lost because remodelling becomes unbalanced after midlife. Most cortical bone loss occurs by intracortical, not endocortical remodelling. Each remodelling event removes more bone than deposited enlarging existing canals which eventually coalesce eroding and thinning the cortex from 'within.' Thus, there is a need to study the decay of cortical as well as trabecular bone, and to develop drugs that restore the strength of both types of bone. It is now possible to accurately quantify cortical porosity and trabecular decay in vivo. The challenges still to be met are to determine whether measurement of porosity identifies persons at risk for fracture, whether this approach is compliments information obtained using bone densitometry, and whether changes in cortical porosity and other microstructural traits have the sensitivity to serve as surrogates of treatment success or failure.

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Close layer
Original Articles
Clinical Study
Association of Waist-Height Ratio with Diabetes Risk: A 4-Year Longitudinal Retrospective Study
Yoon Jeong Son, Jihyun Kim, Hye-Jeong Park, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee
Endocrinol Metab. 2016;31(1):127-133.   Published online March 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.1.127
  • 4,194 View
  • 36 Download
  • 24 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   
Background

Waist-to-height ratio (WHtR) is an easy and inexpensive adiposity index that reflects central obesity. In this study, we examined the association of various baseline adiposity indices, including WHtR, with the development of diabetes over 4 years of follow-up in apparently healthy Korean individuals.

Methods

A total of 2,900 nondiabetic participants (mean age, 44.3 years; 2,078 men) in a health screening program, who repeated the medical check-up in 2005 and 2009, were recruited. Subjects were divided into two groups according to development of diabetes after 4 years. The cut-off values of baseline body mass index (BMI), waist circumference (WC), and WHtR for the development of diabetes over 4 years were calculated. The sensitivity, specificity, and mean area under the receiver operator characteristic curve (AUROC) of each index were assessed. The odds ratio (OR) for diabetes development was analyzed for each of the three baseline adiposity indices.

Results

During the follow-up period, 101 new cases (3.5%) of diabetes were diagnosed. The cut-off WHtR value for diabetes development was 0.51. Moreover, WHtR had the highest AUROC value for diabetes development among the three adiposity indices (0.716, 95% confidence interval [CI], 0.669 to 0.763; 0.702, 95% CI, 0.655 to 0.750 for WC; 0.700, 95% CI, 0.651 to 0.750 for BMI). After adjusting for confounding variables, the ORs of WHtR and WC for diabetes development were 1.95 (95% CI, 1.14 to 3.34) and 1.96 (95% CI, 1.10 to 3.49), respectively. No significant differences were observed between the two groups regarding BMI.

Conclusion

Increased baseline WHtR and WC correlated with the development of diabetes after 4 years. WHtR might be a useful screening measurement to identify individuals at high risk for diabetes.

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Close layer
Clinical Study
Association between Bsm1 Polymorphism in Vitamin D Receptor Gene and Diabetic Retinopathy of Type 2 Diabetes in Korean Population
Yong Joo Hong, Eun Seok Kang, Myoung Jin Ji, Hyung Jin Choi, Taekeun Oh, Sung-Soo Koong, Hyun Jeong Jeon
Endocrinol Metab. 2015;30(4):469-474.   Published online December 31, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.4.469
  • 4,010 View
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  • 23 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   
Background

Type 2 diabetes is one of the most common diseases with devastating complications. However, genetic susceptibility of diabetic complications has not been clarified. The vitamin D endocrine system is related with calcification and lipolysis, insulin secretion, and may be associated with many complicated disease including diabetes and cardiovascular disease. Recent studies reported that single nucleotide polymorphisms of vitamin D receptor (VDR) gene were associated with diabetic complications.

Methods

In present study, we evaluated the association of BsmI polymorphism of VDR with diabetic complications in Korean diabetes patients. Total of 537 type 2 diabetic subjects from the Endocrinology Clinic of Chungbuk National University Hospital were investigated. Polymerase chain reaction-restriction fragment length polymorphism was used to test the genotype and allele frequency of BsmI (rs1544410; BB, Bb, bb) polymorphisms.

Results

Mean age was 62.44±10.64 years and mean disease duration was 13.65±7.39 years. Patients with B allele (BB or Bb) was significantly associated with lower risk of diabetic retinopathy (severe non-proliferative diabetic retinopathy or proliferative retinopathy; 7.4%, 5/68) compared with patients without B allele (bb; 17.3%, 81/469; P=0.035). This association was also significant after adjusting for hemoglobin A1c level, body mass index, age, sex, and diabetes mellitus duration, concurrent dyslipidemia and hypertension (odds ratio, 2.99; 95% confidence interval, 1.08 to 8.29; P=0.035) in logistic regression analysis.

Conclusion

Our findings suggest that B allele of Bsm1 polymorphism in VDR gene is associated with lower risk of diabetic retinopathy in type 2 diabetic patients. Bsm1 genotype could be used as a susceptibility marker to predict the risk of diabetes complication.

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Close layer
Clinical Study
A 5-Year Prospective Follow-Up Study of Lipid-Rich Adrenal Incidentalomas: No Tumor Growth or Development of Hormonal Hypersecretion
Camilla Schalin-Jäntti, Merja Raade, Esa Hämäläinen, Timo Sane
Endocrinol Metab. 2015;30(4):481-487.   Published online December 31, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.4.481
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  • 41 Download
  • 22 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   
Background

Current guidelines for follow-up of adrenal incidentalomas are extensive and hampered by lack of follow-up studies. We tested the hypothesis that small lipid-rich adrenal incidentalomas, initially characterized by tumor size <40 mm and <10 Hounsfield units (HUs) on unenhanced computed tomography (CT) may not demonstrate excessive growth/hormonal hypersecretion on follow-up.

Methods

Sixty-nine incidentalomas in 56 patients were restudied with unenhanced CT and screening for hypercortisolism (dexamethasone suppression test [DST], plasma adrenocorticotropic hormone) and pheochromocytoma (24-hour urinary metanephrines and normetanephrines) 5 years later. Primary hyperaldosteronism was excluded at base-line.

Results

Tumor (n=69) size was similar before and after 5 years follow-up (19±6 mm vs. 20±7 mm). Mean tumor growth was 1±2 mm. Largest increase in tumor size was 8 mm, this tumor was surgically removed and histopathology confirmed cortical adenoma. DST was normal in 54 patients and two patients (3.6%) were still characterized by subclinical hypercortisolism. Initial tumor size was >20 mm for the patient with largest tumor growth and those with subclinical hypercortisolism. All patients had normal 24-hour urinary metanephrines and normetanephrines. Low attenuation (<10 HU) was demonstrated in 97% of 67 masses re-evaluated with unenhanced CT.

Conclusion

None of the patients developed clinically relevant tumor growth or new subclinical hypercortisolism. Biochemical screening for pheochromocytoma in incidentalomas demonstrating <10 HU on unenhanced CT is not needed. For such incidentalomas <40 mm, it seems sufficient to perform control CT and screen for hypercortisolism after 5 years.

Citations

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Close layer
Case Report
Thyroid
Accelerated Disease Progression after Discontinuation of Sorafenib in a Patient with Metastatic Papillary Thyroid Cancer
Kyung-Jin Yun, Woohyeon Kim, Eun Hee Kim, Min-Hee Kim, Dong-Jun Lim, Moo-Il Kang, Bong-Yun Cha
Endocrinol Metab. 2014;29(3):388-393.   Published online September 25, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.3.388
  • 3,433 View
  • 30 Download
  • 23 Web of Science
  • 22 Crossref
AbstractAbstract PDFPubReader   

Distant metastases from papillary thyroid carcinoma (PTC) are rare and are associated with a poor prognosis. Here, we describe a patient with metastatic PTC who was treated with a tyrosine kinase inhibitor (TKI, sorafenib) for several months that was acutely exacerbated by discontinuation. A 43-year-old male was diagnosed with PTC in February 2004 and underwent total thyroidectomy followed by two courses of high-dose radioactive iodine (RAI) therapy. Despite two additional courses of high-dose RAI therapy, lung and muscle metastases were developed. Treatment with sorafenib was begun in September 2010. After 11 months treatment of sorafenib, newly developed metastatic lesions were found in mediastinal lymph nodes, liver, and bones. Considered as treatment failure, the administration of sorafenib was discontinued. Two weeks after sorafenib treatment was stopped, the disease progressed abruptly and caused death of the patient by respiratory failure. In our patient, PTC progressed rapidly after the cessation of sorafenib treatment. Patients with several other types of cancer have also experienced such rapid disease progression, termed "flare-ups." Physicians should be aware that flare-ups may occur in advanced PTC patients following the cessation of TKI therapy.

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Close layer
Special Article
Miscellaneous
COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society
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
Endocrinol Metab. 2021;36(4):757-765.   Published online August 17, 2021
DOI: https://doi.org/10.3803/EnM.2021.404
  • 10,065 View
  • 415 Download
  • 19 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   ePub   
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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Close layer
Review Article
Obesity and Metabolism
Food Preferences and Obesity
Sara Spinelli, Erminio Monteleone
Endocrinol Metab. 2021;36(2):209-219.   Published online April 19, 2021
DOI: https://doi.org/10.3803/EnM.2021.105
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  • 278 Download
  • 20 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   ePub   
Obesity is a multifactorial disease with several potential causes that remain incompletely understood. Recent changes in the environment, which has become increasingly obesogenic, have been found to interact with individual factors. Evidence of the role of taste responsiveness and food preference in obesity has been reported, pointing to a lower taste sensitivity and a higher preference and intake of fat and, to a lesser extent, sweet foods in obese people. Studies in the last decades have also suggested that individual differences in the neurophysiology of food reward may lead to overeating, contributing to obesity. However, further studies are needed to confirm these findings. In fact, only a limited number of studies has been conducted on large samples, and several studies were conducted only on women. Larger balanced studies in terms of sex/gender and age are required in order to control the confounding effect of these variables. As many factors are intertwined in obesity, a multidisciplinary approach is needed. This will allow a better understanding of taste alteration and food behaviours in obese people in order to design more effective strategies to promote healthier eating and to prevent obesity and the related chronic disease risks.

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Close layer
Original Articles
Clinical Study
The Association of Overt and Subclinical Hyperthyroidism with the Risk of Cardiovascular Events and Cardiovascular Mortality: Meta-Analysis and Systematic Review of Cohort Studies
Seo Young Sohn, Eunyoung Lee, Min Kyung Lee, Jae Hyuk Lee
Endocrinol Metab. 2020;35(4):786-800.   Published online November 25, 2020
DOI: https://doi.org/10.3803/EnM.2020.728
  • 5,828 View
  • 285 Download
  • 18 Web of Science
  • 21 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Whether hyperthyroidism is an independent risk factor for cardiovascular events remains controversial. We aimed to evaluate the association of overt and subclinical hyperthyroidism with the risk of ischemic heart disease (IHD), stroke, heart failure, and cardiovascular mortality.
Methods
Studies regarding the association between hyperthyroidism and cardiovascular events were searched on PubMed and Embase databases. The cardiovascular disease (CVD) risk was classified as high and low, based on pre-existing diseases, including history of coronary, cerebral, or peripheral artery disease; heart failure; atrial fibrillation; diabetes mellitus; or chronic kidney disease.
Results
Thirty-seven cohort studies were included in this meta-analysis. The pooled hazard ratio for subjects with overt hyperthyroidism compared with the control group was 1.11 (95% confidence interval [CI], 1.03 to 1.19) for IHD, 1.35 (95% CI, 1.03 to 1.75) for stroke, and 1.20 (95% CI, 1.00 to 1.46) for cardiovascular mortality. For subjects with subclinical hyperthyroidism, the pooled hazard ratio was 1.24 (95% CI, 1.07 to 1.45) for IHD, when compared with the control group. Subgroup analysis by CVD risk showed that the risk of stroke in overt hyperthyroidism was increased in the low CVD risk group; however, these association was not observed in the high CVD risk group. Similarly, the risk of IHD in subjects with subclinical hyperthyroidism was significantly increased in the low CVD risk group.
Conclusion
Overt hyperthyroidism is associated with increased risk of IHD, stroke, and cardiovascular mortality, and subclinical hyperthyroidism is associated with increased risk of IHD. These associations were particularly observed in the low risk CVD group without underlying CVD.

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Close layer
Clinical Study
Effects of Dipeptidyl Peptidase-4 Inhibitors on Hyperglycemia and Blood Cyclosporine Levels in Renal Transplant Patients with Diabetes: A Pilot Study
Jaehyun Bae, Min Jung Lee, Eun Yeong Choe, Chang Hee Jung, Hye Jin Wang, Myoung Soo Kim, Yu Seun Kim, Joong-Yeol Park, Eun Seok Kang
Endocrinol Metab. 2016;31(1):161-167.   Published online March 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.1.161
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  • 56 Download
  • 21 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   
Background

The use of dipeptidyl peptidase-4 (DPP-4) inhibitors is increasing among renal transplant patients with diabetes. However, the glucose-lowering efficacies of various DPP-4 inhibitors and their effects on blood cyclosporine levels have not been fully investigated. We compared the glucose-lowering efficacies of DPP 4 inhibitors and evaluate their effects on the blood levels of cyclosporine in renal transplant recipients with diabetes.

Methods

Sixty-five renal allograft recipients who received treatment with DPP-4 inhibitors (vildagliptin, sitagliptin, or linagliptin) following kidney transplant were enrolled. The glucose-lowering efficacies of the DPP-4 inhibitors were compared according to the changes in the hemoglobin A1c (HbA1c) levels after 3 months of treatment. Changes in the trough levels of the cyclosporine were also assessed 2 months after treatment with each DPP-4 inhibitor.

Results

HbA1c significantly decreased in the linagliptin group in comparison with other DPP-4 inhibitors (vildagliptin –0.38%±1.03%, sitagliptin –0.53%±0.95%, and linagliptin –1.40±1.34; P=0.016). Cyclosporine trough levels were significantly increased in the sitagliptin group compared with vildagliptin group (30.62±81.70 ng/mL vs. –24.22±53.54 ng/mL, P=0.036). Cyclosporine trough levels were minimally changed in patients with linagliptin.

Conclusion

Linagliptin demonstrates superior glucose-lowering efficacy and minimal effect on cyclosporine trough levels in comparison with other DPP-4 inhibitors in kidney transplant patients with diabetes.

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Close layer
Review Article
Thyroid
Indications for Fine Needle Aspiration in Thyroid Nodules
Jin Young Kwak
Endocrinol Metab. 2013;28(2):81-85.   Published online June 18, 2013
DOI: https://doi.org/10.3803/EnM.2013.28.2.81
  • 5,329 View
  • 51 Download
  • 22 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   

Thyroid nodules are a common clinical problem with the widespread use of ultrasonography. Fine needle aspiration (FNA) is the mainstay for diagnosing a thyroid malignancy. There have been several guidelines on when to perform FNA in thyroid nodules. This review is based on several published recommendations and helps physicians easily understand the factors favoring FNA.

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Original Article
Obesity and Metabolism
Increased Risk of Diabetes Development in Subjects with the Hypertriglyceridemic Waist Phenotype: A 4-Year Longitudinal Study
Ki Joong Han, Shin Yeoung Lee, Nam Hee Kim, Hyun Beom Chae, Tae Hoon Lee, Choel Min Jang, Kyung Mo Yoo, Hae Jung Park, Min Kyung Lee, Won Seon Jeon, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee
Endocrinol Metab. 2014;29(4):514-521.   Published online December 29, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.4.514
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  • 21 Crossref
AbstractAbstract PDFPubReader   
Background

The hypertriglyceridemic waist (HTGW) phenotype is a simple and inexpensive screening parameter to identify people at increased risk of cardiovascular disease. We evaluated whether the HTGW phenotype predicts diabetes in urban Korean adults.

Methods

A total of 2,900 nondiabetic subjects (mean age 44.3 years), comprising 2,078 males (71.7%) and 822 females (28.3%) who underwent annual medical check-ups at our center between January 2005 and December 2009, were recruited. The subjects were divided into four groups according to baseline serum triglyceride (TG) level and waist circumference (WC): normal WC-normal TG (NWNT) level, normal WC-high TG level, enlarged WC-normal TG level, and enlarged WC-high TG (EWHT) level. High serum TG level was defined as ≥150 mg/dL and enlarged WC was defined as ≥90 cm for men and ≥85 cm for women. New cases of diabetes were determined according to questionnaires filled in by participants and the diagnostic criteria of the American Diabetes Association. Cox proportional hazards model analysis was used to assess the association of HTGW phenotype with the incidence of diabetes.

Results

A total of 101 (3.5%) new diabetes cases were diagnosed during the study period. The EWHT group had a higher incidence of diabetes (8.3%) compared with the NWNT group (2.2%). The adjusted hazard ratio for diabetes for subjects with the EWHT phenotype at baseline was 4.113 (95% confidence interval [CI], 2.397 to 7.059) after adjustment for age, and 2.429 (95% CI, 1.370 to 4.307) after adjustment for age, sex, total cholesterol, systolic blood pressure, and alcohol drinking history. It was attenuated by inclusion of baseline fasting glucose level in the model.

Conclusion

Subjects with the HTGW phenotype showed the highest risk of incident diabetes. This tool could be useful for identifying individuals at high risk of diabetes.

Citations

Citations to this article as recorded by  
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Endocrinol Metab : Endocrinology and Metabolism