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Volume 35(2); June 2020
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Review Articles
Miscellaneous
Encountering COVID-19 as Endocrinologists
Eun-Jung Rhee, Jung Hee Kim, Sun Joon Moon, Won-Young Lee
Endocrinol Metab. 2020;35(2):197-205.   Published online June 23, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.197
  • 13,225 View
  • 277 Download
  • 13 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   ePub   
The world is entering an era of disaster and chaos due to coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2. Since its first emergence in December 2019 in Wuhan, China, COVID-19 has swept through Asia and propagated throughout the world to Europe and North America. As of April 13, 1,773,084 people were infected and 111,652 people had died from COVID-19 globally, and new record levels of infection are being reported every day. Based on the data that have been amassed so far, the primary risk factors for a severe disease course or even mortality from COVID-19 are underlying diseases such as diabetes and hypertension. As the global prevalence of diabetes continues to increase, patients with endocrine diseases such as diabetes mellitus and those who are on long-term corticosteroid therapy due to adrenal insufficiency or hypopituitarism are at risk for a poor prognosis of COVID-19. As endocrinologists, we would like to briefly review the current knowledge about the relationship between COVID-19 and endocrine diseases and to discuss what we can do for the safety and health of our patients with endocrine diseases in this globally threatening situation.

Citations

Citations to this article as recorded by  
  • 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
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  • COVID-19 and diabetes: Association intensify risk factors for morbidity and mortality
    Prateek Sharma, Tapan Behl, Neelam Sharma, Sukhbir Singh, Ajmer Singh Grewal, Ali Albarrati, Mohammed Albratty, Abdulkarim M. Meraya, Simona Bungau
    Biomedicine & Pharmacotherapy.2022; 151: 113089.     CrossRef
  • The Relationship between COVID-19 and Hypothalamic–Pituitary–Adrenal Axis: A Large Spectrum from Glucocorticoid Insufficiency to Excess—The CAPISCO International Expert Panel
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    RamakanthBhargav Panchangam, Pradeep Puthenveetil, SunilKumar Kota, Sabaretnam Mayilvaganan
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  • Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects
    G. Lisco, A. De Tullio, E. Jirillo, V. A. Giagulli, G. De Pergola, E. Guastamacchia, V. Triggiani
    Journal of Endocrinological Investigation.2021; 44(9): 1801.     CrossRef
  • Effects of a DPP-4 Inhibitor and RAS Blockade on Clinical Outcomes of Patients with Diabetes and COVID-19
    Sang Youl Rhee, Jeongwoo Lee, Hyewon Nam, Dae-Sung Kyoung, Dong Wook Shin, Dae Jung Kim
    Diabetes & Metabolism Journal.2021; 45(2): 251.     CrossRef
  • 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
    Endocrinology and Metabolism.2021; 36(4): 757.     CrossRef
  • Collateral Damage of the COVID‐19 Pandemic on Nutritional Quality and Physical Activity: Perspective from South Korea
    Soo Lim, Hyunjung Lim, Jean‐Pierre Després
    Obesity.2020; 28(10): 1788.     CrossRef
  • Diabetes mellitus and COVID-19 in the post-acute phase patients - possible links with physical and rehabilitation medicine and balneotherapy
    Constantin Munteanu, Diana-Loreta PĂUN, Alina-Maria ȘUȚĂ, Simin Aysel FLORESCU, Gelu ONOSE, Mihail Hoteteu
    Balneo Research Journal.2020; 11(Vol.11, no): 350.     CrossRef
  • Managing Diabetes During the COVID-19 Pandemic
    John Doupis, Konstantinos Avramidis
    European Endocrinology.2020; 16(2): 85.     CrossRef
  • Independent Impact of Diabetes on the Severity of Coronavirus Disease 2019 in 5,307 Patients in South Korea: A Nationwide Cohort Study
    Sun Joon Moon, Eun-Jung Rhee, Jin-Hyung Jung, Kyung-Do Han, Sung-Rae Kim, Won-Young Lee, Kun-Ho Yoon
    Diabetes & Metabolism Journal.2020; 44(5): 737.     CrossRef
  • SARS-CoV-2 (COVID-19) and the Endocrine System
    Michelle D Lundholm, Caroline Poku, Nicholas Emanuele, Mary Ann Emanuele, Norma Lopez
    Journal of the Endocrine Society.2020;[Epub]     CrossRef
Close layer
Hypothalamus and Pituitary gland
Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?
Cheol Ryong Ku, Vladimir Melnikov, Zhaoyun Zhang, Eun Jig Lee
Endocrinol Metab. 2020;35(2):206-216.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.206
  • 6,672 View
  • 250 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDFPubReader   ePub   
Acromegaly presents with an enigmatic range of symptoms and comorbidities caused by chronic and progressive growth hormone elevations, commonly due to endocrinologic hypersecretion from a pituitary gland tumor. Comprehensive national acromegaly databases have been appearing over the years, allowing for international comparisons of data, although still presenting varying prevalence and incidence rates. Lack of large-scale analysis in geographical and ethnic differences in clinical presentation and management requires further research. Assessment of current and novel predictors of responsiveness to distinct therapy can lead to multilevel categorization of patients, allowing integration into new clinical guidelines and reduction of increased morbidity and mortality associated with acromegaly. This review compares current data from epidemiological studies and assesses the present-day application of prognostic factors in medical practice, the reality of precision therapy, as well as its future prospects in acromegaly, with a special focus on its relevance to the South Korean population.

Citations

Citations to this article as recorded by  
  • Biomarkers of response to treatment in acromegaly
    Leandro Kasuki, Elisa Lamback, Ximene Antunes, Mônica R. Gadelha
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    Kyungwon Kim, Cheol Ryong Ku, Eun Jig Lee
    Endocrinology and Metabolism.2023; 38(5): 463.     CrossRef
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    Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    European Journal of Endocrinology.2023; 189(3): 363.     CrossRef
  • The Future of Somatostatin Receptor Ligands in Acromegaly
    Monica R Gadelha, Luiz Eduardo Wildemberg, Leandro Kasuki
    The Journal of Clinical Endocrinology & Metabolism.2022; 107(2): 297.     CrossRef
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    Leandro Kasuki, Mônica R. Gadelha
    Best Practice & Research Clinical Endocrinology & Metabolism.2022; 36(6): 101679.     CrossRef
  • Risk of Neurodegenerative Diseases in Patients With Acromegaly
    Sangmo Hong, Kyungdo Han, Kyung-Soo Kim, Cheol-Young Park
    Neurology.2022;[Epub]     CrossRef
  • Machine Learning-based Prediction Model for Treatment of Acromegaly With First-generation Somatostatin Receptor Ligands
    Luiz Eduardo Wildemberg, Aline Helen da Silva Camacho, Renan Lyra Miranda, Paula C L Elias, Nina R de Castro Musolino, Debora Nazato, Raquel Jallad, Martha K P Huayllas, Jose Italo S Mota, Tobias Almeida, Evandro Portes, Antonio Ribeiro-Oliveira, Lucio Vi
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    Florica Sandru, Adelina Popa, Dan Paduraru, Alexandru Filipescu, Mara Carsote, Adina Ghemigian
    Experimental and Therapeutic Medicine.2021;[Epub]     CrossRef
Close layer
Obesity and Metabolism
Effects of Cardiovascular Risk Factor Variability on Health Outcomes
Seung-Hwan Lee, Mee Kyoung Kim, Eun-Jung Rhee
Endocrinol Metab. 2020;35(2):217-226.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.217
  • 9,165 View
  • 193 Download
  • 26 Web of Science
  • 28 Crossref
AbstractAbstract PDFPubReader   ePub   
Innumerable studies have suggested “the lower, the better” for cardiovascular risk factors, such as body weight, lipid profile, blood pressure, and blood glucose, in terms of health outcomes. However, excessively low levels of these parameters cause health problems, as seen in cachexia, hypoglycemia, and hypotension. Body weight fluctuation is related to mortality, diabetes, obesity, cardiovascular disease, and cancer, although contradictory findings have been reported. High lipid variability is associated with increased mortality and elevated risks of cardiovascular disease, diabetes, end-stage renal disease, and dementia. High blood pressure variability is associated with increased mortality, myocardial infarction, hospitalization, and dementia, which may be caused by hypotension. Furthermore, high glucose variability, which can be measured by continuous glucose monitoring systems or self-monitoring of blood glucose levels, is associated with increased mortality, microvascular and macrovascular complications of diabetes, and hypoglycemic events, leading to hospitalization. Variability in metabolic parameters could be affected by medications, such as statins, antihypertensives, and hypoglycemic agents, and changes in lifestyle patterns. However, other mechanisms modify the relationships between biological variability and various health outcomes. In this study, we review recent evidence regarding the role of variability in metabolic parameters and discuss the clinical implications of these findings.

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Close layer
Thyroid
Amino Acid Transporters as Potential Therapeutic Targets in Thyroid Cancer
Keisuke Enomoto, Muneki Hotomi
Endocrinol Metab. 2020;35(2):227-236.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.227
  • 6,718 View
  • 171 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract PDFPubReader   ePub   
Thyroid cancer cells have a high amino acid demand for proliferation, invasion, and metastasis. Amino acids are taken up by thyroid cancer cells, both thyroid follicular cell and thyroid parafollicular cells (commonly called “C-cells”), via amino acid transporters. Amino acid transporters up-regulate in many cancers, and their expression level associate with clinical aggressiveness and prognosis. This is the review to discuss the therapeutic potential of amino acid transporters and as molecular targets in thyroid cancer.

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Close layer
Hypothalamus and Pituitary gland
Epidemiology of Functioning Pituitary Adenomas
Sang Ouk Chin
Endocrinol Metab. 2020;35(2):237-242.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.237
  • 7,852 View
  • 254 Download
  • 11 Web of Science
  • 12 Crossref
AbstractAbstract PDFPubReader   ePub   
Pituitary adenomas (PAs) are defined as benign monoclonal tumors in the pituitary gland that cause symptoms due to either hormonal hypersecretion or a space-occupying effect, and are classified as functioning or non-functioning. Because of their rarity and slow-growing with symptomless nature in most cases, it has been challenging to investigate the epidemiology of PAs. Considering their public health impact and association with increased morbidity and mortality, however, it is essential to understand the prevalence and incidence of PAs in order to improve patient outcomes and to minimize the resultant burden on the health care system. Fortunately, developments in imaging modalities and easier access to large-scale population data have enabled investigators to analyze the epidemiology of PAs more accurately. This review summarizes previously reported epidemiologic data on functioning PAs in Korea and other countries.

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Obesity and Metabolism
Noninvasive Evaluation of Nonalcoholic Fatty Liver Disease
Dae Ho Lee
Endocrinol Metab. 2020;35(2):243-259.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.243
  • 10,997 View
  • 296 Download
  • 19 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   ePub   
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver diseases and can progress to advanced fibrosis and end-stage liver disease. Thus, intensive research has been performed to develop noninvasive methods for the diagnosis of nonalcoholic steatohepatitis (NASH) and fibrosis. Currently, no single noninvasive tool covers all of the stages of pathologies and conditions of NAFLD, and the cost and feasibility of known techniques are also important issues. Blood biomarkers for NAFLD may be useful to select subjects who need ultrasonography (US) screening for NAFLD, and noninvasive tools for assessing fibrosis may be helpful to exclude the probability of significant fibrosis and to predict advanced fibrosis, thus guiding the decision of whether to perform liver biopsy in patients with NAFLD. Among various methods, magnetic resonance-based methods have been shown to perform better than other methods in assessing steatosis as well as in detecting hepatic fibrosis. Many genetic markers are associated with the development and progression of NAFLD. Further well-designed studies are needed to determine which biomarker panels, imaging studies, genetic marker panels, or combinations thereof perform well for diagnosing NAFLD, differentiating NASH and fibrosis, and following-up NAFLD, respectively.

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Close layer
Diabetes
Recent Updates on Vascular Complications in Patients with Type 2 Diabetes Mellitus
Chan-Hee Jung, Ji-Oh Mok
Endocrinol Metab. 2020;35(2):260-271.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.260
  • 7,538 View
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  • 13 Web of Science
  • 11 Crossref
AbstractAbstract PDFPubReader   ePub   
It is well known that patients with type 2 diabetes mellitus (T2DM) are at an increased risk of morbidity and mortality from atherosclerotic cardiovascular (CV) complications. Previously, the concept that diabetes mellitus (DM) is a “coronary artery disease (CAD) risk equivalent” was widely accepted, implying that all DM patients should receive intensive management. However, considerable evidence exist for wide heterogeneity in the risk of CV events among T2DM patients and the concept of a “CAD risk equivalent” has changed. Recent guidelines recommend further CV risk stratification in T2DM patients, with treatment tailored to the risk level. Although imaging modalities for atherosclerotic cardiovascular disease (ASCVD) have been used to improve risk prediction, there is currently no evidence that imaging-oriented therapy improves clinical outcomes. Therefore, controversy remains whether we should screen for CVD in asymptomatic T2DM. The coexistence of T2DM and heart failure (HF) is common. Based on recent CV outcome trials, sodium glucose cotransporter-2 inhibitors and glucagon like peptide-1 receptor agonists are recommended who have established ASCVD, indicators of high risk, or HF because of their demonstrated benefits for CVD. These circumstances have led to an increasing emphasis on ASCVD and HF in T2DM patients. In this review, we examine the literature published within the last 5 years on the risk assessment of CVD in asymptomatic T2DM patients. In particular, we review recent guidelines regarding screening for CVD and research focusing on the role of coronary artery calcium, coronary computed tomography angiography, and carotid intima-media thickness in asymptomatic T2DM patients.

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Special Article
Miscellaneous
Diagnosis and Treatment of Growth Hormone Deficiency: A Position Statement from Korean Endocrine Society and Korean Society of Pediatric Endocrinology
Jung Hee Kim, Hyun Wook Chae, Sang Ouk Chin, Cheol Ryong Ku, Kyeong Hye Park, Dong Jun Lim, Kwang Joon Kim, Jung Soo Lim, Gyuri Kim, Yun Mi Choi, Seong Hee Ahn, Min Ji Jeon, Yul Hwangbo, Ju Hee Lee, Bu Kyung Kim, Yong Jun Choi, Kyung Ae Lee, Seong-Su Moon, Hwa Young Ahn, Hoon Sung Choi, Sang Mo Hong, Dong Yeob Shin, Ji A Seo, Se Hwa Kim, Seungjoon Oh, Sung Hoon Yu, Byung Joon Kim, Choong Ho Shin, Sung-Woon Kim, Chong Hwa Kim, Eun Jig Lee
Endocrinol Metab. 2020;35(2):272-287.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.272
  • 9,383 View
  • 426 Download
  • 13 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   ePub   
Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

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Editorial
Thyroid
Association of Serum Progranulin Levels with Progression of Papillary Thyroid Cancer
Won Gu Kim
Endocrinol Metab. 2020;35(2):288-289.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.288
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  • 81 Download
  • 1 Web of Science
  • 1 Crossref
PDFPubReader   ePub   

Citations

Citations to this article as recorded by  
  • Can serum progranulin level be used as a prognostic biomarker in non-small cell lung cancer?
    Nevin Taci Hoca, Ebru Ünsal, Koza Murat, Arzu Ertürk, Nermin Çapan
    Monaldi Archives for Chest Disease.2022;[Epub]     CrossRef
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Original Articles
Clinical Study
Fasting and Postprandial Hyperglycemia: Their Predictors and Contributions to Overall Hyperglycemia in Korean Patients with Type 2 Diabetes
Jaecheol Moon, Ji Young Kim, Soyeon Yoo, Gwanpyo Koh
Endocrinol Metab. 2020;35(2):290-297.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.290
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  • 5 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Background
This study aimed to identify factors that affect fasting hyperglycemia (FHG) and postprandial hyperglycemia (PPG) and their contributions to overall hyperglycemia in Korean patients with type 2 diabetes mellitus (T2DM).
Methods
This was a retrospective study conducted on 194 Korean T2DM patients with 7-point self-monitoring blood glucose (SMBG) profiles plotted in 4 days in 3 consecutive months. We calculated the areas corresponding to FHG and PPG (area under the curve [AUC]FHG and AUCPPG) and contributions (%) in the graph of the 7-point SMBG data. The levels of glycated hemoglobin (HbA1c) were categorized by tertiles, and the contributions of FHG and PPG were compared.
Results
The relative contribution of FHG increased (44.7%±5.6%, 58.0%±4.4%, 66.5%±2.8%; PANOVA=0.002, PTREND <0.001), while that of PPG decreased (55.3%±5.5%, 42.0%±4.4%, 33.5%±2.8%; PANOVA=0.002, PTREND <0.001) with the elevated HbA1c. Multivariate analysis showed that HbA1c (β=0.615, P<0.001), waist circumference (β=0.216, P=0.042), and triglyceride (β=0.121, P=0.048) had a significant association with AUCFHG. Only HbA1c (β=0.231, P=0.002) and age (β=0.196, P=0.009) was significantly associated with AUCPPG.
Conclusion
The data suggested that in Korean T2DM patients, FHG predominantly contributed to overall hyperglycemia at higher HbA1c levels, whereas it contributed to PPG at lower HbA1c levels. It is recommended that certain factors, namely age, degree of glycemic control, obesity, or triglyceride levels, should be considered when prescribing medications for T2DM patients.

Citations

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  • Prospective study of the association between chronotype and cardiometabolic risk among Chinese young adults
    Tingting Li, Yang Xie, Shuman Tao, Liwei Zou, Yajuan Yang, Fangbiao Tao, Xiaoyan Wu
    BMC Public Health.2023;[Epub]     CrossRef
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    Kyung-Soo Kim, Sangmo Hong, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
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    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
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Clinical Study
Effects of a Portfolio-Mediterranean Diet and a Mediterranean Diet with or without a Sterol-Enriched Yogurt in Individuals with Hypercholesterolemia
Yvelise Ferro, Elisa Mazza, Mariantonietta Salvati, Emma Santariga, Salvatore Giampà, Rocco Spagnuolo, Patrizia Doldo, Roberta Pujia, Adriana Coppola, Carmine Gazzaruso, Arturo Pujia, Tiziana Montalcini
Endocrinol Metab. 2020;35(2):298-307.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.298
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  • 140 Download
  • 5 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
A growing number of functional foods have been proposed to reduce cholesterol levels and the Portfolio Diet, which includes a combination of plant sterols, fibres, nuts, and soy protein, reduces low density lipoprotein cholesterol (LDL-C) from 20% to 30% in individuals with hyperlipidaemia. In this pilot study, the aim was to investigate whether a Mediterranean Diet incorporating a new and simple combination of cholesterol-lowering foods, excluding soy and nuts (namely the Portfolio-Mediterranean Diet), would reduce LDL-C levels, in the short-term, better than a Mediterranean Diet plus a sterol-enriched yogurt or a Mediterranean Diet alone.
Methods
We retrospectively evaluated 24 individuals on a Portfolio-Mediterranean Diet and 48 matched individuals on a Mediterranean Diet with or without a sterol-enriched yogurt (24 each groups) as controls.
Results
At follow-up (after 48±12 days), we observed an LDL reduction of 21±4, 23±4, and 44±4 mg/dL in the Mediterranean Diet alone, Mediterranean Diet plus yogurt and Portfolio-Mediterranean Diet respectively (P<0.001).
Conclusion
A Portfolio-Mediterranean Diet, incorporating a new combination of functional foods such as oats or barley, plant sterols, chitosan, and green tea but not soy and nuts, may reduce LDL of 25% in the short term in individuals with hypercholesterolemia.

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    Carla Navarro, Juan Salazar, María P. Díaz, Maricarmen Chacin, Raquel Santeliz, Ivana Vera, Luis D′Marco, Heliana Parra, Mary Carlota Bernal, Ana Castro, Daniel Escalona, Henry García-Pacheco, Valmore Bermúdez
    Heliyon.2023; 9(8): e18239.     CrossRef
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    Ying Wang, Tao Wang, Zhangtie Wang, Yiwen Guo, Ruijie Liu, Ming Chang
    Journal of the Science of Food and Agriculture.2023; 103(15): 7764.     CrossRef
  • Phyto-Enrichment of Yogurt to Control Hypercholesterolemia: A Functional Approach
    Harsh Kumar, Kanchan Bhardwaj, Natália Cruz-Martins, Ruchi Sharma, Shahida Anusha Siddiqui, Daljeet Singh Dhanjal, Reena Singh, Chirag Chopra, Adriana Dantas, Rachna Verma, Noura S. Dosoky, Dinesh Kumar
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  • Familial Hypercholesterolemia and Its Current Diagnostics and Treatment Possibilities: A Literature Analysis
    Kristina Zubielienė, Gintarė Valterytė, Neda Jonaitienė, Diana Žaliaduonytė, Vytautas Zabiela
    Medicina.2022; 58(11): 1665.     CrossRef
  • Mediterranean Diet a Potential Strategy against SARS-CoV-2 Infection: A Narrative Review
    Yvelise Ferro, Roberta Pujia, Samantha Maurotti, Giada Boragina, Angela Mirarchi, Patrizia Gnagnarella, Elisa Mazza
    Medicina.2021; 57(12): 1389.     CrossRef
Close layer
Clinical Study
Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
Hana Kim, Sung Hye Kong, Jae Hoon Moon, Sang Yoon Kim, Kay-Hyun Park, Jun Sung Kim, Joong Haeng Choh, Young Joo Park, Cheong Lim
Endocrinol Metab. 2020;35(2):308-318.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.308
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  • 151 Download
  • 9 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The aim of this study was to determine the associations between subclinical hypothyroidism (SCH) and long-term cardiovascular outcomes after coronary artery bypass grafting (CABG) or heart valve surgery (HVS).
Methods
We retrospectively reviewed and compared all-cause mortality, cardiovascular mortality, and cardiovascular events in 461 patients who underwent CABG and 104 patients who underwent HVS.
Results
During a mean±standard deviation follow-up duration of 7.6±3.8 years, there were 187 all-cause deaths, 97 cardiovascular deaths, 127 major adverse cardiovascular events (MACE), 11 myocardial infarctions, one unstable angina, 70 strokes, 30 hospitalizations due to heart failure, 101 atrial fibrillation, and 33 coronary revascularizations. The incidence of all-cause mortality after CABG was significantly higher in patients with SCH (n=36, 55.4%) than in euthyroid patients (n=120, 30.3%), with a hazard ratio of 1.70 (95% confidence interval, 1.10 to 2.63; P=0.018) after adjustment for age, sex, current smoking status, body mass index, underlying diseases, left ventricular dysfunction, and emergency operation. Interestingly, low total triiodothyronine (T3) levels in euthyroid patients who underwent CABG were significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and MACE, but those associations were not observed in HVS patients. Both free thyroxine and thyroid-stimulating hormone levels in euthyroid patients were not related with any cardiovascular outcomes in either the CABG or HVS group.
Conclusion
SCH or low total T3 might be associated with a poor prognosis after CABG, but not after HVS, implying that preoperative thyroid hormonal status may be important in ischemic heart disease patients.

Citations

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  • Subclinical hypothyroidism and clinical outcomes after cardiac surgery: A systematic review and meta-analysis
    Michele Dell’Aquila, Camilla S. Rossi, Tulio Caldonazo, Gianmarco Cancelli, Lamia Harik, Giovanni J. Soletti, Kevin R. An, Jordan Leith, Hristo Kirov, Mudathir Ibrahim, Michelle Demetres, Arnaldo Dimagli, Mohamed Rahouma, Mario Gaudino
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    Hiba Masri-Iraqi, Yaron Rudman, Carmel Friedrich Dubinchik, Idit Dotan, Talia Diker-Cohen, Liat Sasson, Tzipora Shochat, Ilan Shimon, Eyal Robenshtok, Amit Akirov
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    Dong Zhao, Wei Zhao, Chuangshi Wang, Fei Xu, Wei Zhao, Xieraili Tiemuerniyazi, Hao Ma, Wei Feng
    Interdisciplinary CardioVascular and Thoracic Surgery.2023;[Epub]     CrossRef
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    Olena K. Gogayeva, Anatoliy V. Rudenko, Vasyl V. Lazoryshynets, Serhii A. Rudenko, Tetiana A. Andrushchenko
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    Shi-Pan Wang, Yuan Xue, Hai-Yang Li, Wen-Jian Jiang, Hong-Jia Zhang
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    Petra Kleinbongard, Philipp Kuthan, Chantal Eickelmann, Philipp Jakobs, Joachim Altschmied, Judith Haendeler, Arjang Ruhparwar, Matthias Thielmann, Gerd Heusch
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    Jiun-Yu Lin, Pei-Chi Kao, Yi-Ting Tsai, Chi-Hsiang Chung, Wu-Chien Chien, Chih-Yuan Lin, Chieh-Hua Lu, Chien-Sung Tsai
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Close layer
Clinical Study
Relationships between Thigh and Waist Circumference, Hemoglobin Glycation Index, and Carotid Plaque in Patients with Type 2 Diabetes
Myung Ki Yoon, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm, Kap Bum Huh, Chul Sik Kim
Endocrinol Metab. 2020;35(2):319-328.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.319
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AbstractAbstract PDFPubReader   ePub   
Background
This study investigated the relationships of thigh and waist circumference with the hemoglobin glycation index (HGI) and carotid atherosclerosis in patients with type 2 diabetes.
Methods
This observational study included 3,075 Korean patients with type 2 diabetes, in whom anthropometric measurements and carotid ultrasonography were conducted. HGI was defined as the measured hemoglobin A1c (HbA1c) level minus the predicted HbA1c level, which was calculated using the linear relationship between HbA1c and fasting plasma glucose levels. Carotid atherosclerosis was defined as a clearly isolated focal plaque or focal wall thickening >50% of the surrounding intima-media thickness.
Results
The frequency of a positive HGI decreased with increasing thigh circumference in men and increased with increasing waist circumference in women after adjusting for potential confounding variables. Thigh and waist circumference had a combined augmentative effect on the likelihood of positive HGI, which was dramatically higher in patients in higher waist-to-thigh ratio quartiles (adjusted odds ratios for the highest compared to the lowest quartile: 1.595 in men and 1.570 in women). Additionally, the larger the thigh circumference, the lower the risk of carotid atherosclerosis, although in women, this relationship lacked significance after adjustment for potential confounders.
Conclusion
HGI was associated with thigh circumference in men and waist circumference in women. In addition, the combination of low thigh circumference and high waist circumference was strongly associated with a higher HGI in Korean patients with type 2 diabetes. In particular, thigh circumference was associated with carotid atherosclerosis in men. However, further longitudinal studies are warranted.

Citations

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  • Association between hemoglobin glycation index and subclinical myocardial injury in the general population free from cardiovascular disease
    Zhenwei Wang, Yihai Liu, Jing Xie, Nai-Feng Liu
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(2): 469.     CrossRef
  • Association of Hemoglobin Glycation Index With Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Retrospective Study
    Zhezhe Chen, Duanbin Li, Maoning Lin, Hangpan Jiang, Tian Xu, Yu Shan, Guosheng Fu, Min Wang, Wenbin Zhang
    Frontiers in Physiology.2022;[Epub]     CrossRef
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    Naohiro Taya, Naoto Katakami, Tomoya Mita, Yosuke Okada, Satomi Wakasugi, Hidenori Yoshii, Toshihiko Shiraiwa, Akihito Otsuka, Yutaka Umayahara, Kayoko Ryomoto, Masahiro Hatazaki, Tetsuyuki Yasuda, Tsunehiko Yamamoto, Masahiko Gosho, Iichiro Shimomura, Hi
    Cardiovascular Diabetology.2021;[Epub]     CrossRef
Close layer
Clinical Study
Glycemic Efficacy and Metabolic Consequences of an Empagliflozin Add-on versus Conventional Dose-Increasing Strategy in Patients with Type 2 Diabetes Inadequately Controlled by Metformin and Sulfonylurea
Yujin Shin, Ji Hye Moon, Ho Jun Chin, Ele Ferrannini, Soo Lim
Endocrinol Metab. 2020;35(2):329-338.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.329
  • 6,486 View
  • 213 Download
  • 10 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We assessed the glucose-lowering efficacy of adding empagliflozin versus dose escalating existing medications in patients with uncontrolled type 2 diabetes (T2D).
Methods
This was a 6-month retrospective case-control study in subjects with uncontrolled T2D (glycated hemoglobin [HbA1c] >7%) on conventional treatment. The study group started add-on therapy with empagliflozin (10 mg once a day) while the control group was up-titrated with existing medication, using either monotherapy or a combination of metformin, sulfonylurea, and a dipeptidyl peptidase-4 inhibitor. The primary endpoints included changes in HbA1c, fasting plasma glucose (FPG), and 2-hour postprandial glucose (PP2) levels. Secondary outcomes included changes in body composition, body mass index (BMI), and serum ketone bodies, and urinary excretion of sodium, potassium, chlorine, calcium, phosphorus, and glucose.
Results
After treatment, the reduction in HbA1c was significantly greater in the empagliflozin group than in controls (from 8.6%±1.6% to 7.6%±1.5% vs. 8.5%±1.1% to 8.1%±1.1%; P<0.01). Similar patterns were found in FPG and PP2 levels. Empagliflozin decreased systolic and diastolic blood pressure, triglycerides, and alanine and aspartate aminotransferase levels. Body weight, BMI, waist circumference, fat mass, and abdominal visceral fat area decreased significantly while lean body mass was maintained. Total ketones, β-hydroxybutyrate, and acetoacetate levels increased significantly after empagliflozin.
Conclusion
In addition to glucose lowering, an empagliflozin add-on regimen decreased blood pressure and body fat, and improved metabolic profiles significantly. Empagliflozin add-on is superior to dose escalation in patients with T2D who have inadequate glycemic control on standard medications.

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    Hun Jee Choe, Won Chang, Matthias Blüher, Steven B. Heymsfield, Soo Lim
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    Soo Lim, Minji Sohn, Yujin Shin, Ele Ferrannini
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Close layer
Clinical Study
Long-Term Results of Thermal Ablation of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis
Se Jin Cho, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee
Endocrinol Metab. 2020;35(2):339-350.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.339
  • 10,762 View
  • 306 Download
  • 37 Web of Science
  • 44 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Ultrasound-guided thermal ablations have become one of the main options for treating benign thyroid nodules. To determine efficacy of thermal ablation of benign thyroid nodules, we performed a meta-analysis of studies with long-term follow-up of more than 3 years.
Methods
Databases were searched for studies published up to August 25, 2019, reporting patients with benign thyroid nodules treated with thermal ablation and with follow-up data of more than 3 years. Data extraction and quality assessment were performed according to PRISMA guidelines. The analysis yielded serial volume reduction rates (VRRs) of ablated nodules for up to 3 years or more, and adverse effect of ablation during follow-up. Radiofrequency ablation (RFA) and laser ablation (LA) were compared in a subgroup analysis.
Results
The pooled VRRs for ablated nodules showed rapid volume reduction before 12 months, a plateau from 12 to 36 months, and more volume reduction appearing after 36 months, demonstrating long-term maintenance of treatment efficacy. Thermal ablation had an acceptable complication rate of 3.8%. Moreover, patients undergoing nodule ablation showed no unexpected delayed complications during the follow-up period. In the subgroup analysis, RFA was shown to be superior to LA in terms of the pooled VRR and the number of patients who underwent delayed surgery.
Conclusion
Thermal ablations are safe and effective methods for treating benign thyroid nodules, as shown by a long follow-up analysis of more than 3 years. In addition, RFA showed superior VRRs compared with LA for the treatment of benign thyroid nodules, with less regrowth and less delayed surgery.

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