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Immune Checkpoint Inhibitors and Endocrine Disorders: A Position Statement from the Korean Endocrine Society
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
Endocrinol Metab. 2022;37(6):839-850.   Published online December 26, 2022
DOI: https://doi.org/10.3803/EnM.2022.1627
  • 3,208 View
  • 317 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDFPubReader   ePub   
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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Citations to this article as recorded by  
  • 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
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Review Article
Diabetes, Obesity and Metabolism
Recent Updates to Clinical Practice Guidelines for Diabetes Mellitus
Jin Yu, Seung-Hwan Lee, Mee Kyoung Kim
Endocrinol Metab. 2022;37(1):26-37.   Published online February 28, 2022
DOI: https://doi.org/10.3803/EnM.2022.105
  • 15,325 View
  • 1,100 Download
  • 16 Web of Science
  • 18 Crossref
AbstractAbstract PDFPubReader   ePub   
Guidelines for the management of patients with diabetes have become an important part of clinical practice that improve the quality of care and help establish evidence-based medicine in this field. With rapidly accumulating evidence on various aspects of diabetes care, including landmark clinical trials of treatment agents and newer technologies, timely updates of the guidelines capture the most current state of the field and present a consensus. As a leading academic society, the Korean Diabetes Association publishes practice guidelines biennially and the American Diabetes Association does so annually. In this review, we summarize the key changes suggested in the most recent guidelines. Some of the important updates include treatment algorithms emphasizing comorbid conditions such as atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease in the selection of anti-diabetic agents; wider application of continuous glucose monitoring (CGM), insulin pump technologies and indices derived from CGM such as time in range; more active screening of subjects at high-risk of diabetes; and more detailed individualization in diabetes care. Although there are both similarities and differences among guidelines and some uncertainty remains, these updates provide a good approach for many clinical practitioners who are battling with diabetes.

Citations

Citations to this article as recorded by  
  • Use of Diabetes Medications before and after a Heart Failure–Related Hospitalization among Nursing Home Residents
    Tingting Zhang, Andrew R. Zullo, Kaleen (Kaley) N. Hayes, Dae Hyun Kim, Yoojin Lee, Lori A. Daiello, Douglas P. Kiel, Sarah D. Berry
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  • Accuracy and Safety of the 15-Day CareSens Air Continuous Glucose Monitoring System
    Kyung-Soo Kim, Seung-Hwan Lee, Won Sang Yoo, Cheol-Young Park
    Diabetes Technology & Therapeutics.2024;[Epub]     CrossRef
  • Body composition and metabolic syndrome in patients with type 1 diabetes
    Qiong Zeng, Xiao-Jing Chen, Yi-Ting He, Ze-Ming Ma, Yi-Xi Wu, Kun Lin
    World Journal of Diabetes.2024; 15(1): 81.     CrossRef
  • The best internal structure of the Diabetes Quality of Life Measure (DQOL) in Brazilian patients
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  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
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    Kyungdo Han, Bongsung Kim, Seung Hwan Lee, Mee Kyoung Kim
    npj Parkinson's Disease.2023;[Epub]     CrossRef
  • Optimal Low-Density Lipoprotein Cholesterol Level for Primary Prevention in Koreans with Type 2 Diabetes Mellitus
    Ji Yoon Kim, Nam Hoon Kim
    Diabetes & Metabolism Journal.2023; 47(1): 42.     CrossRef
  • Efficacy and safety of enavogliflozin versus dapagliflozin added to metformin plus gemigliptin treatment in patients with type 2 diabetes: A double-blind, randomized, comparator-active study: ENHANCE-D study
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    Diabetes & Metabolism.2023; 49(4): 101440.     CrossRef
  • Finerenone: Efficacy of a New Nonsteroidal Mineralocorticoid Receptor Antagonist in Treatment of Patients With Chronic Kidney Disease and Type 2 Diabetes
    Subo Dey, Jasmine Garg, Andy Wang, Eva Holzner, William H. Frishman, Wilbert S. Aronow
    Cardiology in Review.2023;[Epub]     CrossRef
  • Impact of mental disorders on the risk of heart failure among Korean patients with diabetes: a cohort study
    Tae Kyung Yoo, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee
    Cardiovascular Diabetology.2023;[Epub]     CrossRef
  • Chronic disease management program applied to type 2 diabetes patients and prevention of diabetic complications: a retrospective cohort study using nationwide data
    Min Kyung Hyun, Jang Won Lee, Seung-Hyun Ko
    BMC Public Health.2023;[Epub]     CrossRef
  • Innovative Therapeutic Approaches in Non-Alcoholic Fatty Liver Disease: When Knowing Your Patient Is Key
    Marta Alonso-Peña, Maria Del Barrio, Ana Peleteiro-Vigil, Carolina Jimenez-Gonzalez, Alvaro Santos-Laso, Maria Teresa Arias-Loste, Paula Iruzubieta, Javier Crespo
    International Journal of Molecular Sciences.2023; 24(13): 10718.     CrossRef
  • Association between type 2 diabetes mellitus and depression among Korean midlife women: a cross-sectional analysis study
    You Lee Yang, Eun-Ok Im, Yunmi Kim
    BMC Nursing.2023;[Epub]     CrossRef
  • Access to novel anti-diabetic agents in resource limited settings: A brief commentary
    Poobalan Naidoo, Kiolan Naidoo, Sumanth Karamchand, Rory F Leisegang
    World Journal of Diabetes.2023; 14(7): 939.     CrossRef
  • Comparative efficacy and safety profile of once-weekly Semaglutide versus once-daily Sitagliptin as an add-on to metformin in patients with type 2 diabetes: a systematic review and meta-analysis
    Tirath Patel, Fnu Nageeta, Rohab Sohail, Tooba Shaukat Butt, Shyamala Ganesan, Fnu Madhurita, Muhammad Ahmed, Mahrukh Zafar, Wirda Zafar, Mohammad Uzair Zaman, Giustino Varrassi, Mahima Khatri, Satesh Kumar
    Annals of Medicine.2023;[Epub]     CrossRef
  • Bexagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, for improvement of glycemia in type 2 diabetes mellitus: a systematic review and meta-analysis
    Sagar Dholariya, Siddhartha Dutta, Ragini Singh, Deepak Parchwani, Amit Sonagra, Mehul Kaliya
    Expert Opinion on Pharmacotherapy.2023; 24(18): 2187.     CrossRef
  • Analysis of the management and therapeutic performance of diabetes mellitus employing special target
    Hong-Yan Sun, Xiao-Yan Lin
    World Journal of Diabetes.2023; 14(12): 1721.     CrossRef
  • Zinc Chloride Enhances the Antioxidant Status, Improving the Functional and Structural Organic Disturbances in Streptozotocin-Induced Diabetes in Rats
    Irina Claudia Anton, Liliana Mititelu-Tartau, Eliza Gratiela Popa, Mihaela Poroch, Vladimir Poroch, Ana-Maria Pelin, Liliana Lacramioara Pavel, Ilie Cristian Drochioi, Gina Eosefina Botnariu
    Medicina.2022; 58(11): 1620.     CrossRef
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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
  • 9,983 View
  • 409 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.

Citations

Citations to this article as recorded by  
  • 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
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    C. Ouaddouh, J.W. Duijster, T. Lieber, F.P.A.M. van Hunsel
    Expert Opinion on Drug Safety.2024; 23(3): 323.     CrossRef
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    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
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    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
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  • 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
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    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
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    Frontiers in Physiology.2022;[Epub]     CrossRef
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    Ach Taieb, El Euch Mounira
    Vaccines.2022; 10(12): 2004.     CrossRef
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    Jong Chul Won, Ki-Hyun Baek
    Endocrinology and Metabolism.2022; 37(6): 851.     CrossRef
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    Tania Pilli, Cristina Dalmiglio, Gilda Dalmazio, Alfonso Sagnella, Raffaella Forleo, Lucia Brilli, Fabio Maino, Cristina Ciuoli, Maria Grazia Castagna
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Close layer
Review Articles
Adrenal Gland
Asian Conference on Tumor Ablation Guidelines for Adrenal Tumor Ablation
Byung Kwan Park, Masashi Fujimori, Shu-Huei Shen, Uei Pua
Endocrinol Metab. 2021;36(3):553-563.   Published online June 1, 2021
DOI: https://doi.org/10.3803/EnM.2021.1008
  • 3,533 View
  • 136 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDFPubReader   ePub   
Thermal ablation is a good alternative treatment in patients who are unable to undergo adrenalectomy. Even though the Asian Conference on Tumor Ablation (ACTA) has been held for many years, adrenal ablation guidelines have not been established. No guidelines for adrenal ablation are established in American and European countries, either. The aim of this review was to introduce the first version of ACTA guidelines for adrenal tumor ablation.

Citations

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  • Development and preclinical evaluation of multifunctional hydrogel for precise thermal protection during thermal ablation
    Bowen Zheng, Peng Zhang, Qijun Lv, Tao Wu, Yadong Liu, Junjie Tang, Yanping Ma, Lili Cheng, Langtao Xu, Yizhen Wang, Yifan Xue, Jie Liu, Jie Ren
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  • Treatment of primary aldosteronism: Clinical practice guidelines of the Taiwan Society of Aldosteronism
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    Endocrinology and Metabolism.2023; 38(6): 597.     CrossRef
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Thyroid
Current Guidelines for Management of Medullary Thyroid Carcinoma
Mijin Kim, Bo Hyun Kim
Endocrinol Metab. 2021;36(3):514-524.   Published online June 22, 2021
DOI: https://doi.org/10.3803/EnM.2021.1082
  • 17,040 View
  • 1,631 Download
  • 27 Web of Science
  • 28 Crossref
AbstractAbstract PDFPubReader   ePub   
Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor originating from the parafollicular cells. The diagnostic and therapeutic strategies for the condition are different from those used for well-differentiated thyroid cancer. Since the 2015 American Thyroid Association guidelines for the diagnosis and treatment of MTC, the latest, including the National Comprehensive Cancer Network and European Association for Medical Oncology guidelines have been updated to reflect several recent advances in the management of MTC. Advances in molecular diagnosis and postoperative risk stratification systems have led to individualized treatment and follow-up strategies. Multi-kinase inhibitors, such as vandetanib and cabozantinib, can prolong disease progression-free survival with favorable adverse effects. In addition, potent selective rearranged during transfection (RET) inhibitors (selpercatinib and pralsetinib) have shown a promising efficacy in recent clinical trials. This review summarizes the management of MTC in recent guidelines focused on sporadic MTC.

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    Michał Miciak, Krzysztof Jurkiewicz
    Clinical Cancer Investigation Journal.2023; 12(5): 1.     CrossRef
  • The Evolving Treatment Landscape of Medullary Thyroid Cancer
    Marta Laganà, Valentina Cremaschi, Andrea Alberti, Danica M. Vodopivec Kuri, Deborah Cosentini, Alfredo Berruti
    Current Treatment Options in Oncology.2023; 24(12): 1815.     CrossRef
  • Pralsetinib: chemical and therapeutic development with FDA authorization for the management of RET fusion-positive non-small-cell lung cancers
    Faraat Ali, Kumari Neha, Garima Chauhan
    Archives of Pharmacal Research.2022; 45(5): 309.     CrossRef
  • Psychosocial Characteristics and Experiences in Patients with Multiple Endocrine Neoplasia Type 2 (MEN2) and Medullary Thyroid Carcinoma (MTC)
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    Minh-Khang Le, Masataka Kawai, Toru Odate, Huy Gia Vuong, Naoki Oishi, Tetsuo Kondo
    Endocrine Pathology.2022; 33(3): 348.     CrossRef
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Close layer
Special Article
Adrenal gland
Diagnosis for Pheochromocytoma and Paraganglioma: A Joint Position Statement of the Korean Pheochromocytoma and Paraganglioma Task Force
Eu Jeong Ku, Kyoung Jin Kim, Jung Hee Kim, Mi Kyung Kim, Chang Ho Ahn, Kyung Ae Lee, Seung Hun Lee, You-Bin Lee, Kyeong Hye Park, Yun Mi Choi, Namki Hong, A Ram Hong, Sang-Wook Kang, Byung Kwan Park, Moon-Woo Seong, Myungshin Kim, Kyeong Cheon Jung, Chan Kwon Jung, Young Seok Cho, Jin Chul Paeng, Jae Hyeon Kim, Ohk-Hyun Ryu, Yumie Rhee, Chong Hwa Kim, Eun Jig Lee
Endocrinol Metab. 2021;36(2):322-338.   Published online April 6, 2021
DOI: https://doi.org/10.3803/EnM.2020.908
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  • 555 Download
  • 7 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Pheochromocytoma and paraganglioma (PPGLs) are rare catecholamine-secreting neuroendocrine tumors but can be life-threatening. Although most PPGLs are benign, approximately 10% have metastatic potential. Approximately 40% cases are reported as harboring germline mutations. Therefore, timely and accurate diagnosis of PPGLs is crucial. For more than 130 years, clinical, molecular, biochemical, radiological, and pathological investigations have been rapidly advanced in the field of PPGLs. However, performing diagnostic studies to localize lesions and detect metastatic potential can be still challenging and complicated. Furthermore, great progress on genetics has shifted the paradigm of genetic testing of PPGLs. The Korean PPGL task force team consisting of the Korean Endocrine Society, the Korean Surgical Society, the Korean Society of Nuclear Medicine, the Korean Society of Pathologists, and the Korean Society of Laboratory Medicine has developed this position statement focusing on the comprehensive and updated diagnosis for PPGLs.

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Close layer
Review Article
Hypothalamus and Pituitary gland
Current National and International Guidelines for the Management of Male Hypogonadism: Helping Clinicians to Navigate Variation in Diagnostic Criteria and Treatment Recommendations
Ahmed Al-Sharefi, Richard Quinton
Endocrinol Metab. 2020;35(3):526-540.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.760
  • 9,140 View
  • 491 Download
  • 10 Web of Science
  • 11 Crossref
AbstractAbstract PDFPubReader   ePub   
Male hypogonadism—rebadged by some as testosterone deficiency syndrome—is a clinical and biochemical diagnosis of increasing worldwide interest. Organic male hypogonadism—usually permanent—is well-established, but aging men may also exhibit lower serum testosterone levels; principally due to burden of extra-gonadal comorbidities such as obesity, diabetes and metabolic syndrome, but with an underlying intact hypothalamo-pituitary-testicular (HPT) axis capable of springing back into operation once comorbidities are addressed. Despite encouraging observational data and plausible theoretical underpinning, evidence for efficacy and safety of testosterone in this “aging” group of men is lacking; addressing comorbid illnesses remains the key priority instead. Nevertheless, in recent years, accumulation of misleading information online has triggered a global tsunami of testosterone prescriptions. Despite this, many men with organic hypogonadism remain undiagnosed or untreated; many more face a diagnostic odyssey before achieving care by the appropriate specialist. As testosterone therapy is not without risk several clinical practice guidelines have been published specialist societies to guide physicians on best practice. However, these are heterogeneous in key areas, reflecting divergent approaches to the same evidence basis. Herein, we navigate the major clinical practice guidelines on male hypogonadism and test their respective recommendations against current best evidence.

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Close layer
Special Article
Clinical Guidelines for the Management of Adrenal Incidentaloma
Jung-Min Lee, Mee Kyoung Kim, Seung-Hyun Ko, Jung-Min Koh, Bo-Yeon Kim, Sang Wan Kim, Soo-Kyung Kim, Hae Jin Kim, Ohk-Hyun Ryu, Juri Park, Jung Soo Lim, Seong Yeon Kim, Young Kee Shong, Soon Jib Yoo
Endocrinol Metab. 2017;32(2):200-218.   Published online June 23, 2017
DOI: https://doi.org/10.3803/EnM.2017.32.2.200
  • 15,617 View
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AbstractAbstract PDFPubReader   

An adrenal incidentaloma is an adrenal mass found in an imaging study performed for other reasons unrelated to adrenal disease and often accompanied by obesity, diabetes, or hypertension. The prevalence and incidence of adrenal incidentaloma increase with age and are also expected to rise due to the rapid development of imaging technology and frequent imaging studies. The Korean Endocrine Society is promoting an appropriate practice guideline to meet the rising incidence of adrenal incidentaloma, in cooperation with the Korean Adrenal Gland and Endocrine Hypertension Study Group. In this paper, we discuss important core issues in managing the patients with adrenal incidentaloma. After evaluating core proposition, we propose the most critical 20 recommendations from the initially organized 47 recommendations by Delphi technique.

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Close layer
Review Articles
Thyroid
The Revised 2016 Korean Thyroid Association Guidelines for Thyroid Nodules and Cancers: Differences from the 2015 American Thyroid Association Guidelines
Ka Hee Yi
Endocrinol Metab. 2016;31(3):373-378.   Published online September 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.373
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AbstractAbstract PDFPubReader   

Increased detection of thyroid nodules using high-resolution ultrasonography has resulted in a world-wide increase in the incidence of differentiated thyroid cancer (DTC). Despite the steep increase in its incidence, the age-standardized mortality rate of thyroid cancer has remained stable, which leads toward a trend of more conservative treatment. The latest American Thyroid Association (ATA) guidelines for thyroid nodules and thyroid cancer revised in 2015 suggested that fine needle aspiration biopsy should be performed for thyroid nodules larger than 1 cm and lobectomy might be sufficient for 1 to 4 cm intrathyroidal DTC. In addition, active surveillance instead of immediate surgical treatment was also recommended as a treatment option for papillary thyroid microcarcinoma based on the results of a few observational studies from Japan. The Korean Thyroid Association (KTA) has organized a task force team to develop revised guidelines for thyroid nodules and DTC after an extensive review of articles and intense discussion on whether we should accept the changes in the 2015 ATA guidelines. This paper introduces and discusses the updated major issues and differences in the ATA and the KTA guidelines.

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Close layer
Obesity and Metabolism
The Diabetes Epidemic in Korea
Junghyun Noh
Endocrinol Metab. 2016;31(3):349-353.   Published online August 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.349
  • 6,099 View
  • 48 Download
  • 49 Web of Science
  • 51 Crossref
AbstractAbstract PDFPubReader   

Diabetes is one of the foremost public health issues worldwide that can lead to complications in many organ systems, and has become a significant cause of morbidity and mortality in Korea. According to data from the National Health Insurance Service (NHIS), about 2.7 million Koreans (8.0%) aged 30 years or older had type 2 diabetes mellitus (T2DM) in 2013. The prevalence of T2DM increased with age and rose from 5.6% in 2006 to 8.0% in 2013. Using data based on The Health Screening Service of the NHIS, 25% of Korean adults were reported to have prediabetes in 2013. The prevalence of an impaired fasting glucose tended to increase over time from 21.5% in 2006 to 25.0% in 2013. Even though nationwide health screening has been regularly conducted as a public service, the proportion of undiagnosed cases of diabetes was still reported to be on the higher side in the latest study. Based on the results of these epidemic studies, further actions will be needed to effectively implement lifestyle changes on a social level and increase measures for the early detection of diabetes to stem the tide of the epidemic.

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Close layer
Adrenal gland
Clinical Guidelines for the Diagnosis and Treatment of Cushing's Disease in Korea
Kyu Yeon Hur, Jung Hee Kim, Byung Joon Kim, Min-Seon Kim, Eun Jig Lee, Sung-Woon Kim
Endocrinol Metab. 2015;30(1):7-18.   Published online March 27, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.1.7
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  • 15 Crossref
AbstractAbstract PDFPubReader   

Cushing's disease (CD) is a rare disorder characterized by the overproduction of adrenocorticotropic hormone due to a pituitary adenoma that ultimately stimulates excessive cortisol secretion from the adrenal glands. Prior to the detection of pituitary adenomas, various clinical signs of CD such as central obesity, moon face, hirsutism, and facial plethora are usually already present. Uncontrolled hypercortisolism is associated with metabolic, cardiovascular, and psychological disorders that result in increased mortality. Hence, the early detection and treatment of CD are not only important but mandatory. Because its clinical manifestations vary from patient to patient and are common in other obesity-related conditions, the precise diagnosis of CD can be problematic. Thus, the present set of guidelines was compiled by Korean experts in this field to assist clinicians with the screening, diagnoses, and treatment of patients with CD using currently available tests and treatment modalities.

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Close layer
Obesity and Metabolism
2014 Clinical Practice Guidelines for Overweight and Obesity in Korea
Mee Kyoung Kim, Won-Young Lee, Jae-Heon Kang, Jee-Hyun Kang, Bom Taeck Kim, Seon Mee Kim, Eun Mi Kim, Sang-Hoon Suh, Hye Jung Shin, Kyu Rae Lee, Ki Young Lee, Sang Yeoup Lee, Seon Yeong Lee, Seong-Kyu Lee, Chang Beom Lee, Sochung Chung, In Kyung Jeong, Kyung Yul Hur, Sung Soo Kim, Jeong-taek Woo
Endocrinol Metab. 2014;29(4):405-409.   Published online December 29, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.4.405
  • 8,561 View
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  • 227 Web of Science
  • 246 Crossref
AbstractAbstract PDFPubReader   

The dramatic increase in the prevalence of obesity and its accompanying comorbidities are major health concerns in Korea. Obesity is defined as a body mass index ≥25 kg/m2 in Korea. Current estimates are that 32.8% of adults are obese: 36.1% of men and 29.7% of women. The prevalence of being overweight and obese in national surveys is increasing steadily. Early detection and the proper management of obesity are urgently needed. Weight loss of 5% to 10% is the standard goal. In obese patients, control of cardiovascular risk factors deserves the same emphasis as weight-loss therapy. Since obesity is multifactorial, proper care of obesity requires a coordinated multidisciplinary treatment team, as a single intervention is unlikely to modify the incidence or natural history of obesity.

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Thyroid
The Diagnosis and Management of Hyperthyroidism in Korea: Consensus Report of the Korean Thyroid Association
Jae Hoon Moon, Ka Hee Yi
Endocrinol Metab. 2013;28(4):275-279.   Published online December 12, 2013
DOI: https://doi.org/10.3803/EnM.2013.28.4.275
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AbstractAbstract PDFPubReader   

Hyperthyroidism is one of the causes of thyrotoxicosis and the most common cause of hyperthyroidism in Korea is Graves disease. The diagnosis and treatment of Graves disease are different according to geographical area. Recently, the American Thyroid Association and the American Association of Clinical Endocrinologists suggested new management guidelines for hyperthyroidism. However, these guidelines are different from clinical practice in Korea and are difficult to apply. Therefore, the Korean Thyroid Association (KTA) conducted a survey of KTA members regarding the diagnosis and treatment of hyperthyroidism, and reported the consensus on the management of hyperthyroidism. In this review, we summarized the KTA report on the contemporary practice patterns in the diagnosis and management of hyperthyroidism, and compared this report with guidelines from other countries.

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