Endocrinology and Metabolism

Original Articles

Diabetes
Association between White Blood Cell Counts within Normal Range and Hemoglobin A1c in a Korean Population: Jae Won Hong, Jung Hyun Noh, Dong-Jun Kim; Endocrinol Metab. 2018;33(1):79-87. Published online January 30, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.1.79

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Background

We examined whether white blood cell (WBC) count levels within normal range, could be associated with hemoglobin A1c (HbA1c) levels.

Methods

Among the 11,472 people (≥19 years of age) who participated in the 2011 to 2012 Korea National Health and Nutrition Examination, subjects with chronic disease or illness, including 807 patients with diabetes currently taking anti-diabetic medications and/or 1,149 subjects with WBC levels <4,000 or >10,000/µL were excluded.

Results

Overall, adjusted HbA1c levels increased across the WBC quartiles (5.55%±0.01%, 5.58%±0.01%, 5.60%±0.01%, and 5.65%±0.01%, P<0.001) after adjusting for confounding factors, such as age, gender, fasting plasma glucose, college graduation, smoking history, waist circumference, presence of hypertension, serum total cholesterol, serum triglyceride, and presence of anemia. The adjusted proportions (%) of HbA1c levels of ≥5.7%, ≥6.1%, and ≥6.5% showed significant increases across WBC quartiles (P<0.001, P=0.002, and P=0.022, respectively). Logistic regression analyses of WBC quartiles for the risk of HbA1c levels of ≥5.7%, ≥6.1%, and ≥6.5%, using the variables above as covariates, showed that the odds ratios of the fourth quartile of WBCs were 1.59 (95% confidence interval [CI], 1.35 to 1.89; P<0.001), 1.78 (95% CI, 1.31 to 2.42; P<0.001), and 2.03 (95% CI, 1.13 to 3.64; P=0.018), using the first quartile of WBCs as the reference.

Conclusion

HbA1c levels were positively associated with WBC levels within normal range in a general adult population.

Citations

Citations to this article as recorded by

Vitamin D supplementation modulates glycated hemoglobin (HBA1c) in diabetes mellitus
Asma Akhter, Sultan Alouffi, Uzma Shahab, Rihab Akasha, Mohd Fazal-Ur-Rehman, Mohamed E. Ghoniem, Naved Ahmad, Kirtanjot Kaur, Ramendra Pati Pandey, Ahmed Alshammari, Firoz Akhter, Saheem Ahmad
Archives of Biochemistry and Biophysics.2024; 753: 109911. CrossRef
Glucose indices as inflammatory markers in children with acute surgical abdomen: a cross-sectional study
Hoda Atef Abdelsattar Ibrahim, Sherif Kaddah, Sara Mohamed Elkhateeb, Abeer Aboalazayem, Aya Ahmed Amin, Mahmoud Marei Marei
Annals of Medicine.2023;[Epub] CrossRef
Factors associated with relative muscle strength in patients with type 2 diabetes mellitus
Chiao-Nan Chen, Ting-Chung Chen, Shiow-Chwen Tsai, Chii-Min Hwu
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Non-vascular contributing factors of diabetic foot ulcer severity in national referral hospital of Indonesia
Em Yunir, Dicky L. Tahapary, Tri Juli Edi Tarigan, Dante Saksono Harbuwono, Yoga Dwi Oktavianda, Melly Kristanti, Eni Iswati, Angela Sarumpaet, Pradana Soewondo
Journal of Diabetes & Metabolic Disorders.2021; 20(1): 805. CrossRef
Association between Inflammatory Markers and Glycemic Control in Korean Diabetic Patients
Min Kang, Seok-Joon Sohn
Journal of Health Informatics and Statistics.2021; 46(3): 247. CrossRef
Prediabetes Is Independently Associated with Subclinical Carotid Atherosclerosis: An Observational Study in a Non-Urban Mediterranean Population
Maria Belén Vilanova, Josep Franch-Nadal, Mireia Falguera, Josep Ramon Marsal, Sílvia Canivell, Esther Rubinat, Neus Miró, Àngels Molló, Manel Mata-Cases, Mònica Gratacòs, Esmeralda Castelblanco, Dídac Mauricio
Journal of Clinical Medicine.2020; 9(7): 2139. CrossRef

Adrenal gland
Early Prediction of Long-Term Response to Cabergoline in Patients with Macroprolactinomas: Youngki Lee, Cheol Ryong Ku, Eui-Hyun Kim, Jae Won Hong, Eun Jig Lee, Sun Ho Kim; Endocrinol Metab. 2014;29(3):280-292. Published online September 25, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.3.280

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Abstract PDF PubReader

Background

Cabergoline is typically effective for treating prolactinomas; however, some patients display cabergoline resistance, and the early characteristics of these patients remain unclear. We analyzed early indicators predicting long-term response to cabergoline.

Methods

We retrospectively reviewed the cases of 44 patients with macroprolactinomas who received cabergoline as first-line treatment; the patients were followed for a median of 16 months. The influence of various clinical parameters on outcomes was evaluated.

Results

Forty patients (90.9%) were treated medically and displayed tumor volume reduction (TVR) of 74.7%, a prolactin normalization (NP) rate of 81.8%, and a complete response (CR; TVR >50% with NP, without surgery) rate of 70.5%. Most patients (93.1%) with TVR ≥25% and NP at 3 months eventually achieved CR, whereas only 50% of patients with TVR ≥25% without NP and no patients with TVR <25% achieved CR. TVR at 3 months was strongly correlated with final TVR (R=0.785). Patients with large macroadenomas exhibited a low NP rate at 3 months, but eventually achieved TVR and NP rates similar to those of patients with smaller tumors. Surgery independently reduced the final dose of cabergoline (β=-1.181 mg/week), and two of four patients who underwent surgery were able to discontinue cabergoline.

Conclusion

Determining cabergoline response using TVR and NP 3 months after treatment is useful for predicting later outcomes. However, further cabergoline administration should be considered for patients with TVR >25% at 3 months without NP, particularly those with huge prolactinomas, because a delayed response may be achieved. As surgery can reduce the cabergoline dose necessary for successful disease control, it should be considered for cabergoline-resistant patients.

Citations

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Resistance to dopamine agonists in the treatment of prolactinomas: diagnostic criteria, mechanisms and ways to overcome it
Irena A. Ilovayskaya, Gulnar R. Vagapova
Almanac of Clinical Medicine.2024; 51(7): 397. CrossRef
Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement
Stephan Petersenn, Maria Fleseriu, Felipe F. Casanueva, Andrea Giustina, Nienke Biermasz, Beverly M. K. Biller, Marcello Bronstein, Philippe Chanson, Hidenori Fukuoka, Monica Gadelha, Yona Greenman, Mark Gurnell, Ken K. Y. Ho, Jürgen Honegger, Adriana G.
Nature Reviews Endocrinology.2023; 19(12): 722. CrossRef
Outcome Measures for Medical and Surgical Treatment of Prolactinomas. Is the Role of Surgery Underestimated?
Andrius Anuzis, Kevin O. Lillehei
Journal of Neurological Surgery Part B: Skull Base.2023;[Epub] CrossRef
Are dopamine agonists still the first-choice treatment for prolactinoma in the era of endoscopy? A systematic review and meta-analysis
Xiangming Cai, Junhao Zhu, Jin Yang, Chao Tang, Zixiang Cong, Chiyuan Ma
Chinese Neurosurgical Journal.2022;[Epub] CrossRef
Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors
Renato Cozzi, Maria Rosaria Ambrosio, Roberto Attanasio, Claudia Battista, Alessandro Bozzao, Marco Caputo, Enrica Ciccarelli, Laura De Marinis, Ernesto De Menis, Marco Faustini Fustini, Franco Grimaldi, Andrea Lania, Giovanni Lasio, Francesco Logoluso, M
European Journal of Endocrinology.2022; 186(3): P1. CrossRef
Biochemical Remission after Cabergoline Withdrawal in Hyperprolactinemic Patients with Visible Remnant Pituitary Adenoma
Kyungwon Kim, Yae Won Park, Daham Kim, Sung Soo Ahn, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Cheol Ryong Ku
The Journal of Clinical Endocrinology & Metabolism.2021; 106(2): e615. CrossRef
Surgery is a safe, effective first-line treatment modality for noninvasive prolactinomas
Ji Yong Park, Wonsuk Choi, A Ram Hong, Jee Hee Yoon, Hee Kyung Kim, Woo-Youl Jang, Shin Jung, Ho-Cheol Kang
Pituitary.2021; 24(6): 955. CrossRef
Molecular Pathways in Prolactinomas: Translational and Therapeutic Implications
Betina Biagetti, Rafael Simò
International Journal of Molecular Sciences.2021; 22(20): 11247. CrossRef
A scoping review to understand the indications, effectiveness, and limitations of cabergoline in radiological and biochemical remission of prolactinomas
Rakesh Mishra, SubhasK Konar, Adesh Shrivastava, Pradeep Chouksey, Sumit Raj, Amit Agrawal
Indian Journal of Endocrinology and Metabolism.2021; 25(6): 493. CrossRef
Predictors of dopamine agonist resistance in prolactinoma patients
Elle Vermeulen, Jean D’Haens, Tadeusz Stadnik, David Unuane, Kurt Barbe, Vera Van Velthoven, Sven Gläsker
BMC Endocrine Disorders.2020;[Epub] CrossRef
The Role of Dopamine Agonists in Pituitary Adenomas
Erica A. Giraldi, Adriana G. Ioachimescu
Endocrinology and Metabolism Clinics of North America.2020; 49(3): 453. CrossRef
Prevalence of Thyroid Disease in Patients Surgically Treated for Pituitary Disease
Kim, Cho, Ku, Jung, Moon, Kim, Shin, Kim, Lee
Journal of Clinical Medicine.2019; 8(8): 1142. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef

Review Article

Adrenal gland
Characteristics of Acromegaly in Korea with a Literature Review: Jae Won Hong, Cheol Ryong Ku, Sun Ho Kim, Eun Jig Lee; Endocrinol Metab. 2013;28(3):164-168. Published online September 13, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.3.164

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Abstract PDF PubReader

Acromegaly is a slowly progressive disease caused by excessive growth hormone (GH), which is related to a GH secreting pituitary tumor in most cases. Herein, we describe the epidemiology, clinical characteristics, and treatment of acromegaly in Korea with a literature review. The average annual incidence of acromegaly in Korea was 3.9 cases per million people, which was within the range of previous Western studies. The primary treatment for acromegaly was also transsphenoidal adenomectomy, which accounted for 90.4% of patients whose primary therapeutic options were known. The overall surgical remission rates were 89%, 87%, 64%, 70%, and 50% for modified Hardy classification I, II, IIIA, IIIB, and IV, respectively. An updated and larger study regarding the treatment outcome of medical/radiotherapy in Korean acromegalic patients is needed.

Citations

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Risk of depression in patients with acromegaly in Korea (2006-2016): a nationwide population-based study
Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park
European Journal of Endocrinology.2023; 189(3): 363. CrossRef
Increased Risk of Hip Fracture in Patients with Acromegaly: A Nationwide Cohort Study in Korea
Jiwon Kim, Namki Hong, Jimi Choi, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Sin Gon Kim, Cheol Ryong Ku
Endocrinology and Metabolism.2023; 38(6): 690. CrossRef
Selective screening of patients with associated somatic diseases as a method of early detection of acromegaly
M. B. Antsiferov, V. S. Pronin, T. M. Alekseeva, O. A. Ionova, E. Y. Martynova, Yu. E. Poteshkin, N. A. Chubrova, K. Y. Zherebchikova
Problems of Endocrinology.2021; 67(1): 20. CrossRef
Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?
Cheol Ryong Ku, Vladimir Melnikov, Zhaoyun Zhang, Eun Jig Lee
Endocrinology and Metabolism.2020; 35(2): 206. CrossRef
Patient Characteristics, Diagnostic Delays, Treatment Patterns, Treatment Outcomes, Comorbidities, and Treatment Costs of Acromegaly in China: A Nationwide Study
Xiaopeng Guo, Kailu Wang, Siyue Yu, Lu Gao, Zihao Wang, Huijuan Zhu, Bing Xing, Shuyang Zhang, Dong Dong
Frontiers in Endocrinology.2020;[Epub] CrossRef
Epidemiología de la acromegalia en Ecuador
Enrique López Gavilanez, Kempis Guerrero Franco, Narcisa Solórzano Zambrano, Manuel Navarro Chávez, Camilo López Estrella, Luis Vaca Burbano, Eduardo Marriott Díaz
Endocrinología y Nutrición.2016; 63(7): 333. CrossRef
A magnetic resonance imaging‐based classification system for indication of trans‐sphenoidal hypophysectomy in canine pituitary‐dependent hypercortisolism
A. Sato, T. Teshima, H. Ishino, Y. Harada, T. Yogo, N. Kanno, D. Hasegawa, Y. Hara
Journal of Small Animal Practice.2016; 57(5): 240. CrossRef
Epidemiology of acromegaly in Ecuador
Enrique López Gavilanez, Kempis Guerrero Franco, Narcisa Solórzano Zambrano, Manuel Navarro Chávez, Camilo López Estrella, Luis Vaca Burbano, Eduardo Marriott Díaz
Endocrinología y Nutrición (English Edition).2016; 63(7): 333. CrossRef
An Association Study Between Gene Polymorphisms of Folic Acid Metabolism Enzymes and Biochemical and Hormonal Parameters in Acromegaly
Aslı Tetik Vardarlı, Ayhan Zengi, Vildan Bozok Çetintaş, Muammer Karadeniz, Sadık Tamsel, Ali Şahin Küçükaslan, Timur Köse, Füsun Saygılı, Zuhal Eroglu
Genetic Testing and Molecular Biomarkers.2015; 19(8): 431. CrossRef
Diagnosis, treatment and clinical perspectives of acromegaly
Ferdinand Roelfsema, Gerrit van den Berg
Expert Review of Endocrinology & Metabolism.2015; 10(6): 619. CrossRef
Change in quality of life in patients with acromegaly after treatment with octreotide LAR: first application of AcroQoL in Korea
S. O. Chin, C. H. Chung, Y.-S. Chung, B.-J. Kim, H. Y. Kim, I.-J. Kim, J. G. Kim, M.-S. Kim, S.-Y. Kim, E. J. Lee, K. Y. Lee, S.-W. Kim
BMJ Open.2015; 5(6): e006898. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef

Case Reports

A Case of Latent Autoimmune Diabetes in Adults Developed after Surgical Cure of Growth Hormone Secreting Pituitary Tumor.: Wonjin Kim, Jung Ho Kim, Youngsook Kim, Ji Hye Huh, Su Jin Lee, Mi Sung Park, Eun Yeong Choe, Jeong Kyung Park, Myung Won Lee, Jae Won Hong, Byung Wan Lee, Eun Seok Kang, Bong Soo Cha, Eun Jig Lee, Hyun Chul Lee; Endocrinol Metab. 2012;27(4):318-322. Published online December 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.4.318

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Abstract PDF: Acromegaly is generally caused by a benign growth hormone (GH)-secreting pituitary adenoma. It is characterized by a wide range of complications; cardiovascular, respiratory, bone and joint, and metabolic complications. Among them, impaired glucose tolerance and diabetes mellitus, due to GH-induced insulin resistance, has been reported in approximately 16-46% and 19-56%. They are usually improved following the treatment of acromegaly, surgical or medical therapy. We report a first case of 36-year-old man who was paradoxically diagnosed with GAD antibody positive latent autoimmune diabetes in adults (LADA) after the surgical cure of acromegaly.

Secondary Pituitary Hyperplasia Induced by Hashimoto's Thyroiditis Related Hypothyroidism: A Case Report.: Kwang Joon Kim, Hyun min Kim, Obin Kwon, Eun Young Park, Yong ho Lee, Jae Won Hong, Jin Wi, Eun Jig Lee; J Korean Endocr Soc. 2010;25(1):72-77. Published online March 1, 2010; DOI: https://doi.org/10.3803/jkes.2010.25.1.72

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33 Download
2 Crossref

Abstract PDF

Pituitary hyperplasia associated with untreated primary hypothyroidism in children is a rare condition. There are only a few reports on this condition in children, and especially when pituitary hyperplasia is accompanied with Hashimoto thyroiditis and growth arrest. Here, we describe an unusual association of pituitary hyperplasia with hypothyroidism and growth retardation, and this was all caused by Hashimoto thyroiditis. Hormonal testing showed a low thyroxine level and a high thyroid stimulating hormone level, elevated anti-thyroglobulin, low growth hormone levels and prepubertal levels of gonadotropins. A large intrasellar mass expanding beyond the sella turcica was detected on magnetic resonance imaging (MRI). Homogeneous contrast enhancement of mass highly suggested that it was a pituitary hyperplasia rather than a pituitary tumor. Therapy with L-thyroxine resulted in rapid improvement of the clinical signs, including renewed growth, normalization of the hormone levels and resolution of the pituitary hyperplasia on MRI within 90 days. In children, prolonged unrecognized primary hypothyroidism might be accompanied by growth deficiency and pubertal disharmony. Physicians must be aware of pituitary hyperplasia in these cases.

Citations

Citations to this article as recorded by

Pituitary macroadenoma secondary to Hashimoto’s thyroiditis: inadvertent diagnosis in a pre-pubertal girl
Deepanjan Bhattacharya, Rakesh Kumar, Jaivinder Yadav
Tropical Doctor.2020; 50(3): 240. CrossRef
Pituitary Hyperplasia Secondary to Hypothyroidism Caused by Hashimoto's Thyroiditis in a Female Adolescent
Jeoung Suk Kim, Min Sun Kim, Sun Jun Kim, Gyung Ho Chung, Pyoung Han Hwang, Dae-Yeol Lee
Journal of Korean Society of Pediatric Endocrinology.2011; 16(3): 185. CrossRef

A Case of Insulin Autoimmune Syndrome in a Patient with Partial Hypopituitarism.: Obin Kwon, Eun Young Park, Jin Young Yoon, Kwang Joon Kim, Yong ho Lee, Jae Won Hong, Eun Jig Lee, Sung Kil Lim, Hyun Chul Lee, Bong Soo Cha; J Korean Endocr Soc. 2009;24(4):281-286. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.281

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Abstract PDF: Insulin autoimmune syndrome is one of the rare causes of hypoglycemia, and characterized by hyperinsulinemic hypoglycemia associated with high titer of antibodies to endogenous insulin. We report a case of insulin autoimmune syndrome in a 57-year-old woman, presenting with mental changes due to hypoglycemia. She had no history of diabetes or insulin administration. The serum C-peptide level was 4.69 ng/mL and the insulin concentration was 229.55 microU/mL, when fasting plasma glucose level was 32 mg/dL. The insulin-to-glucose ratio was 7.17, while there was no radiologic evidence of insulinoma. The insulin antibody level was over 100 microU/mL, resulting in the diagnosis of insulin autoimmune syndrome. Hormonal studies revealed partial hypopituitarism and a lack of glucagon-response to hypoglycemia. Hypoglycemia disappeared with replacement of prednisolone with levothyroxine therapy. Under secretion of growth hormone and of adrenocorticotropic hormone due to hypopituitarism were associated with insufficient counterregulation to hypoglycemia. One should keep in mind that insulin autoimmune syndrome or hypopituitarism is one cause of hypoglycemia in patients with no history of diabetes, and corticosteroid can be an effective treatment for both diseases.

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