Endocrinology and Metabolism

Review Article

Diabetes, Obesity and Metabolism
Renal Protection of Mineralocorticoid Receptor Antagonist, Finerenone, in Diabetic Kidney Disease: Dong-Lim Kim, Seung-Eun Lee, Nan Hee Kim; Endocrinol Metab. 2023;38(1):43-55. Published online February 27, 2023; DOI: https://doi.org/10.3803/EnM.2022.1629

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Chronic kidney disease (CKD) is the most common cause of end-stage renal disease in patients with type 2 diabetes mellitus (T2DM). CKD increases the risk of cardiovascular diseases; therefore, its prevention and treatment are important. The prevention of diabetic kidney disease (DKD) can be achieved through intensive glycemic control and blood pressure management. Additionally, DKD treatment aims to reduce albuminuria and improve kidney function. In patients with T2DM, renin-angiotensin-aldosterone system inhibitors, sodium glucose cotransporter 2 inhibitors, and glucagon-like peptide-1 receptor agonists can delay the progression of DKD. Hence, there is a need for novel treatments that can effectively suppress DKD progression. Finerenone is a first-in-class nonsteroidal mineralocorticoid receptor antagonist with clinically proven efficacy in improving albuminuria, estimated glomerular filtration rate, and risk of cardiovascular events in early and advanced DKD. Therefore, finerenone is a promising treatment option to delay DKD progression. This article reviews the mechanism of renal effects and major clinical outcomes of finerenone in DKD.

Citations

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Neue Antihypertensiva im Renin-Angiotensin-Aldosteron-System
Markus van der Giet
CardioVasc.2024; 24(1): 33. CrossRef
Chicoric acid advanced PAQR3 ubiquitination to ameliorate ferroptosis in diabetes nephropathy through the relieving of the interaction between PAQR3 and P110α pathway
Weiwei Zhang, Yong Liu, Jiajun Zhou, Teng Qiu, Haitang Xie, Zhichen Pu
Clinical and Experimental Hypertension.2024;[Epub] CrossRef
Endothelial CXCR2 deficiency attenuates renal inflammation and glycocalyx shedding through NF-κB signaling in diabetic kidney disease
Siyuan Cui, Xin Chen, Jiayu Li, Wei Wang, Deqi Meng, Shenglong Zhu, Shiwei Shen
Cell Communication and Signaling.2024;[Epub] CrossRef
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection
Alessio Mazzieri, Francesca Porcellati, Francesca Timio, Gianpaolo Reboldi
International Journal of Molecular Sciences.2024; 25(7): 3969. CrossRef
Epigenetic modification in diabetic kidney disease
Zhe Liu, Jiahui Liu, Wanning Wang, Xingna An, Ling Luo, Dehai Yu, Weixia Sun
Frontiers in Endocrinology.2023;[Epub] CrossRef
Novel Approaches in Chronic Renal Failure without Renal Replacement Therapy: A Review
Sandra Martínez-Hernández, Martín Muñoz-Ortega, Manuel Ávila-Blanco, Mariana Medina-Pizaño, Javier Ventura-Juárez
Biomedicines.2023; 11(10): 2828. CrossRef
Finerenone and other future therapeutic options for Alport syndrome
Helen Pearce, Holly Mabillard
Journal of Rare Diseases.2023;[Epub] CrossRef

Original Articles

Diabetes, Obesity and Metabolism
Sleep Duration and the Risk of Type 2 Diabetes: A Community-Based Cohort Study with a 16-Year Follow-up: Da Young Lee, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Seung Ku Lee, Chol Shin, Nan Hee Kim; Endocrinol Metab. 2023;38(1):146-155. Published online February 6, 2023; DOI: https://doi.org/10.3803/EnM.2022.1582

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Background
We aimed to investigate the moderating effects of obesity, age, and sex on the association between sleep duration and the development of diabetes in Asians.
Methods
We analyzed data from a cohort of the Korean Genome and Epidemiology Study conducted from 2001 to 2020. After excluding shift workers and those with diabetes at baseline, 7,407 participants were stratified into three groups according to sleep duration: ≤5 hours/night, >5 to 7 hours/night (reference), and >7 hours/night. The Cox proportional hazards analyses were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes mellitus (T2DM). Subgroup analyses were performed according to obesity, age, and sex.
Results
During 16 years of follow-up, 2,024 cases of T2DM were identified. Individuals who slept ≤5 h/night had a higher risk of incident diabetes than the reference group (HR, 1.17; 95% CI, 1.02 to 1.33). The subgroup analysis observed a valid interaction with sleep duration only for obesity. A higher risk of T2DM was observed in the ≤5 hours/night group in non-obese individuals, men, and those aged <60 years, and in the >7 hours/night group in obese individuals (HRs were 1.34 [95% CI, 1.11 to 1.61], 1.22 [95% CI, 1 to 1.49], and 1.18 [95% CI, 1.01 to 1.39], respectively).
Conclusion
This study confirmed the effect of sleep deprivation on the risk of T2DM throughout the 16-year follow-up period. This impact was confined to non-obese or young individuals and men. We observed a significant interaction between sleep duration and obesity.

Citations

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Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes
Da Young Lee, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Nan Hee Kim
Diabetes & Metabolism Journal.2024; 48(1): 37. CrossRef
Role of Sleep and Sleep Disorders in Cardiometabolic Risk: a Review and Update
Shaden O. Qasrawi, Ahmed S. BaHammam
Current Sleep Medicine Reports.2024; 10(1): 34. CrossRef
Evaluating reliability in wearable devices for sleep staging
Vera Birrer, Mohamed Elgendi, Olivier Lambercy, Carlo Menon
npj Digital Medicine.2024;[Epub] CrossRef
All That Glitters Is Not Gold: The Same Sleep Time, but Different Diabetogenic Outcomes
Bohye Kim, Obin Kwon
Endocrinology and Metabolism.2023; 38(1): 78. CrossRef
The Link Between Sleeping and Type 2 Diabetes: A Systematic Review
Ali Darraj
Cureus.2023;[Epub] CrossRef

Clinical Study
Impact of the Dynamic Change of Metabolic Health Status on the Incident Type 2 Diabetes: A Nationwide Population-Based Cohort Study: Jung A Kim, Da Hye Kim, Seon Mee Kim, Yong Gyu Park, Nan Hee Kim, Sei Hyun Baik, Kyung Mook Choi, Kyungdo Han, Hye Jin Yoo; Endocrinol Metab. 2019;34(4):406-414. Published online December 23, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.4.406

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Background

Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals.

Methods

We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO.

Results

During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain.

Conclusion

Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index.

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Hye Ah Lee, Hyesook Park
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Aditya Verma, Ashok Jha, Ahmed Roshdy Alagorie, Rishi Sharma
Eye.2023; 37(2): 303. CrossRef
From Metabolic Syndrome to Type 2 Diabetes in Youth
Dario Iafusco, Roberto Franceschi, Alice Maguolo, Salvatore Guercio Nuzio, Antonino Crinò, Maurizio Delvecchio, Lorenzo Iughetti, Claudio Maffeis, Valeria Calcaterra, Melania Manco
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Daye Diana Choi, Kyung-Ah Park, Kyungdo Han, Sei Yeul Oh
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New metabolic health definition might not be a reliable predictor for diabetes in the nonobese Chinese population
Liying Li, Ziqiong Wang, Haiyan Ruan, Muxin Zhang, Linxia Zhou, Xin Wei, Ye Zhu, Jiafu Wei, Xiaoping Chen, Sen He
Diabetes Research and Clinical Practice.2022; 184: 109213. CrossRef
Metabolically healthy obesity: Is it really healthy for type 2 diabetes mellitus?
Qi Wu, Ming-Feng Xia, Xin Gao
World Journal of Diabetes.2022; 13(2): 70. CrossRef
Metabolically obese phenotype and its dynamic change are associated with increased carotid intima-media thickness: Results from a cohort study
Liping Yang, Xue Li, Li Wang, Shan Xu, Yanmei Lou, Fulan Hu
Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(9): 2238. CrossRef
Obesity Metabolic Phenotype, Changes in Time and Risk of Diabetes Mellitus in an Observational Prospective Study on General Population
Chan Yang, Xiaowei Liu, Yuanyuan Dang, Juan Li, Jingyun Jing, Di Tian, Jiangwei Qiu, Jiaxing Zhang, Ni Yan, Xiuying Liu, Yi Zhao, Yuhong Zhang
International Journal of Public Health.2022;[Epub] CrossRef
Implications of metabolic health status and obesity on the risk of kidney cancer: A nationwide population-based cohort study
Yun Kyung Cho, Hwi Seung Kim, Joong-Yeol Park, Woo Je Lee, Ye-Jee Kim, Chang Hee Jung
Frontiers in Endocrinology.2022;[Epub] CrossRef
Metabolic health is a determining factor for incident colorectal cancer in the obese population: A nationwide population‐based cohort study
Yun Kyung Cho, Jiwoo Lee, Hwi Seung Kim, Joong‐Yeol Park, Woo Je Lee, Ye‐Jee Kim, Chang Hee Jung
Cancer Medicine.2021; 10(1): 220. CrossRef
Cumulative Exposure to Metabolic Syndrome Components and the Risk of Dementia: A Nationwide Population-Based Study
Yunjung Cho, Kyungdo Han, Da Hye Kim, Yong-Moon Park, Kun-Ho Yoon, Mee Kyoung Kim, Seung-Hwan Lee
Endocrinology and Metabolism.2021; 36(2): 424. CrossRef
Excessive Intake of High-Fructose Corn Syrup Drinks Induces Impaired Glucose Tolerance
Hidemi Hattori, Yuma Hanai, Yuto Oshima, Hiroaki Kataoka, Nozomu Eto
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The risk of Alzheimer’s disease according to dynamic changes in metabolic health and obesity: a nationwide population-based cohort study
Yun Kyung Cho, Jiwoo Lee, Hwi Seung Kim, Joong-Yeol Park, Woo Je Lee, Ye-Jee Kim, Chang Hee Jung
Aging.2021; 13(13): 16974. CrossRef
Metabolically healthy obesity: predictors of transformation to unhealthy phenotype in St Petersburg population (according to the ESSE-RF study)
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"Arterial’naya Gipertenziya" ("Arterial Hypertension").2021; 27(3): 279. CrossRef
Physiological and Lifestyle Traits of Metabolic Dysfunction in the Absence of Obesity
Hanna Bjørk Klitgaard, Jesper Hoffmann Kilbak, Erica Arhnung Nozawa, Ann V. Seidel, Faidon Magkos
Current Diabetes Reports.2020;[Epub] CrossRef
Exploring Therapeutic Targets to Reverse or Prevent the Transition from Metabolically Healthy to Unhealthy Obesity
Tenzin D. Dagpo, Christopher J. Nolan, Viviane Delghingaro-Augusto
Cells.2020; 9(7): 1596. CrossRef
Prepregnancy smoking and the risk of gestational diabetes requiring insulin therapy
Mee Kyoung Kim, Kyungdo Han, Sang Youn You, Hyuk-Sang Kwon, Kun-Ho Yoon, Seung-Hwan Lee
Scientific Reports.2020;[Epub] CrossRef
Obesity with and without type 2 diabetes: are there differences in obesity history, lifestyle factors or concomitant pathology?
E. A. Shestakova, Yu. I. Yashkov, O. Yu. Rebrova, M. V. Kats, M. D. Samsonova, I. I. Dedov
Obesity and metabolism.2020; 17(4): 332. CrossRef

Effects of Vildagliptin or Pioglitazone on Glycemic Variability and Oxidative Stress in Patients with Type 2 Diabetes Inadequately Controlled with Metformin Monotherapy: A 16-Week, Randomised, Open Label, Pilot Study: Nam Hoon Kim, Dong-Lim Kim, Kyeong Jin Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim; Endocrinol Metab. 2017;32(2):241-247. Published online June 23, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.241

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Background

Glycemic variability is associated with the development of diabetic complications through the activation of oxidative stress. This study aimed to evaluate the effects of a dipeptidyl peptidase 4 inhibitor, vildagliptin, or a thiazolidinedione, pioglitazone, on glycemic variability and oxidative stress in patients with type 2 diabetes.

Methods

In this open label, randomised, active-controlled, pilot trial, individuals who were inadequately controlled with metformin monotherapy were assigned to either vildagliptin (50 mg twice daily, n=17) or pioglitazone (15 mg once daily, n=14) treatment groups for 16 weeks. Glycemic variability was assessed by calculating the mean amplitude of glycemic excursions (MAGE), which was obtained from continuous glucose monitoring. Urinary 8-iso prostaglandin F₂α, serum oxidised low density lipoprotein, and high-sensitivity C-reactive protein were used as markers of oxidative stress or inflammation.

Results

Both vildagliptin and pioglitazone significantly reduced glycated hemoglobin and mean plasma glucose levels during the 16-week treatment. Vildagliptin also significantly reduced the MAGE (from 93.8±38.0 to 70.8±19.2 mg/dL, P=0.046), and mean standard deviation of 24 hours glucose (from 38±17.3 to 27.7±6.9, P=0.026); however, pioglitazone did not, although the magnitude of decline was similar in both groups. Markers of oxidative stress or inflammation including urinary 8-iso prostaglandin F₂α did not change after treatment in both groups.

Conclusion

In this 16-week treatment trial, vildagliptin, but not pioglitazone, reduced glycemic variability in individuals with type 2 diabetes who was inadequately controlled with metformin monotherapy, although a reduction of oxidative stress markers was not observed.

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Sahar Hossam Elhini, Amal K. Hussien, Ahmed Abd Elsamie Omran, Asmaa A. Elsayed, Haitham saeed
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Case Reports

Adrenal gland
Pheochromocytoma with Markedly Abnormal Liver Function Tests and Severe Leukocytosis: Chai Ryoung Eun, Jae Hee Ahn, Ji A Seo, Nan Hee Kim; Endocrinol Metab. 2014;29(1):83-90. Published online March 14, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.1.83

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Pheochromocytoma is a rare neuroendocrine tumor arising from the medulla of the adrenal glands, which causes an overproduction of catecholamines. The common symptoms are headache, palpitations, and sweating; however, various other clinical manifestations might also be present. Accurate diagnosis of pheochromocytoma is important because surgical treatment is usually successful, and associated clinical problems are reversible if treated early. A 49-year-old man with a history of uncontrolled hypertension and diabetes mellitus presented with chest pain, fever, and sweating. His liver function tests and white blood cell counts were markedly increased and his echocardiography results suggested stress-induced cardiomyopathy. His abdominal computed tomography showed a 5×5-cm-sized tumor in the left adrenal gland, and laboratory tests confirmed catecholamine overproduction. After surgical resection of the left adrenal gland, his liver function tests and white blood cell counts normalized, and echocardiography showed normal cardiac function. Moreover, his previous antihypertensive regimen was deescalated, and his previously uncontrolled blood glucose levels normalized without medication.

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Motaz A Selim, Krystal Weierstahl, Calvin Eriksen, Terra Pearson, Harvey Woehlck
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A Case of Multiple Osteoporotic Compression Fractures in Young Man with Budd-Chiari Syndrome.: Sun Hwa Kim, Tae Un Yang, Byeong Kwang Choi, Hye Jin Yoo, Ji A Seo, Kyung Mook Choi, Nan Hee Kim, Sin Gon Kim, Sei Hyun Baik, Dong Seop Choi, Hae Yoon Choi; Endocrinol Metab. 2012;27(4):334-339. Published online December 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.4.334

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Abstract PDF: Osteoporosis in young men is extremely rare. In this report, we demonstrate a rare case of multiple vertebral fractures discovered in a young man with Budd-Chiari syndrome without prior history of trauma. A 29-year-old man was diagnosed as Budd-Chiari syndrome 12 years ago and underwent a mesocaval shunt to relieve the hepatic vein obstruction and was on warfarin therapy. He suffered from low back pain and it was not relieved by analgesics. A T-L spine X-ray revealed multiple compression fractures and the z-score at lumbar spine was -3.7 which is below the expected range for that age. The patient was treated with calcium, vitamin D and bisphosphonate, and showed clinical improvement. This case highlights the importance of the investigation for secondary osteoporosis in young adults with an underlying disease that alters bone metabolism.

Original Article

Thyroid Dysfunction of North Korean Women Living in South Korea, Focusing on Subclinical Hypothyroidism.: Joo Hyung Kim, Sol Ah Park, Nam Hoon Kim, Jae Hee Ahn, Yoon Jung Kim, Myongjin Cho, Yoon Jung Lee, Hye Jin Yoo, Hee Young Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim; Endocrinol Metab. 2012;27(3):200-207. Published online September 19, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.3.200

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Abstract PDF

BACKGROUND
Thyroid function depends on ethnic and environmental factors. North Korean refugees have the same genetic background as South Koreans, but they have been exposed to different environments. This study examines the prevalence and pattern of thyroid disorders in North Korean women living in South Korea, focusing on subclinical hypothyroidism (SCH). METHODS: The intended sample was a total of 327 North Korean women residing in Seoul. Health questionnaires and medical examinations, including serum thyrotropin (thyroid stimulating hormone, TSH), free thyroxine, and thyroid autoantibodies, were conducted. RESULTS: The prevalence of SCH was 9.4%. In logistic regression analysis, smoking, menopause, length of stay in South Korea, body mass index, history of thyroid disease, and metabolic syndrome were not associated with the risk of SCH. Whereas, the positivity of autoantibodies were associated with a high risk for SCH (odds ratio [OR], 4.840; 95% confidence interval [CI], 1.80-13.017; P = 0.002), and age was associated with a low risk for SCH (OR, 0.94; 95% CI, 0.888-0.994; P = 0.031). The serum TSH levels also decreased with increasing age, and in particular, there was significant difference between 30-39 years, and over 60 years (2.33 +/- 1.51 microIU/mL vs. 1.54 +/- 0.73 microIU/mL, P = 0.028). CONCLUSION: In North Korean women, the positivity of autoantibodies was associated with a high risk for SCH. But interestingly, a younger age was associated with a high risk for SCH. Considering that they suffered from severe famine at the period of growth, and this led to malnutrition, their thyroid dysfunction might be associated with the peculiar environment that they experienced.

Citations

Citations to this article as recorded by

Systematic review of evidence on public health in the Democratic People’s Republic of Korea
John J Park, Ah-Young Lim, Hyung-Soon Ahn, Andrew I Kim, Soyoung Choi, David HW Oh, Owen Lee-Park, Sharon Y Kim, Sun Jae Jung, Jesse B Bump, Rifat Atun, Hee Young Shin, Kee B Park
BMJ Global Health.2019; 4(2): e001133. CrossRef
Environmental Factors and Thyroid Dysfunction
Hyun-Kyung Chung
Endocrinology and Metabolism.2012; 27(3): 191. CrossRef

Case Reports

Hyperprolactinemia-Associated Breast Uptake of Radioiodine Following 131I Postablation Scan in Differentiated Thyroid Cancer.: Jae Hee Ahn, Sun Young Kim, Ye Ji Kim, Suk Young Lee, Jae Hyoung Lee, Seung Hun Kang, Ho Cheol Hong, Sae Jeong Yang, Hye Jin Yoo, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Hae Yoon Choi; Endocrinol Metab. 2011;26(4):345-347. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.345

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Abstract PDF

Scanning with whole-body 131I scintigraphy after surgery has been a valuable diagnostic modality in the surveillance of patients with differentiated thyroid cancer. Radioiodine uptake is rarely observed in non-lactating breast tissue, which mimics thyroid cancer metastasis. We now report a case of a 45-year-old female thyroid cancer patient who underwent radioiodine therapy, and in whom breast uptake of radioiodine was observed on a post-therapy whole body scan. Her serum prolactin level was elevated to 328 ng/mL at the time of the radioiodine uptake, and the hyperprolactinemia was induced by her antipsychotic medications. Six months after she discontinued that medication, her serum prolactin level was normalized to 12.6 ng/mL and breast uptake of iodine was no longer present in a follow-up whole body scan.

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Incidental Findings of Intense Radioiodine Uptake in Struma Ovarii and Bilateral Nonlactating Breasts Simultaneously on Postablation 131I SPECT/CT for Papillary Thyroid Cancer
Hye-kyung Shim, Mi Ra Kim
Nuclear Medicine and Molecular Imaging.2016; 50(4): 353. CrossRef

Successful Localization of Distant Metastasis in Parathyroid Carcinoma Using Intraoperative Parathyroid Hormone Assay.: Ho Cheol Hong, Sun Won Kim, Tae Hyung Kim, In Hye Cha, Jae Hee Ahn, Hye Jin Yoo, Hee Young Kim, Ji A Seo, Hyun Koo Kim, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Jae Bok Lee, Sei Hyun Baik, Dong Seop Choi; Endocrinol Metab. 2011;26(1):92-96. Published online March 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.1.92

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Abstract PDF

Intra-operative parathyroid hormone (IOPTH) assay is a useful tool to confirm complete excision of all hyper-functioning parathyroid gland tissue. In this report, we describe a case with successful localization of distant metastasis in a patient with parathyroid carcinoma using the IOPTH assay. A 53-year-old man presented to our clinic with a serum calcium level of 11.8 mg/dL and an intact PTH level of 233.3 pg/mL. He had been treated for parathyroid carcinoma eleven years ago. Two suspected metastatic lesions were detected on the chest computed tomography. Due to the vastly different surgical field necessary to excise each lesion, we preferentially removed only one lesion and we monitored the other remaining suspected lesion without resection via IOPTH assay. Six months later, the patient's serum calcium and intact PTH levels remained within their normal ranges. To the best of our knowledge, this is the first case to effectively utilize IOPTH assay for the management of metastatic parathyroid carcinoma.

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The association of abdominal obesity, obesity and parathyroid hormone in Korean adults (aged≥50 years): The Korea National Health and Nutrition Survey, 2011
Kyu Su Lee, Yo Sang Yoon, Hyun Yoon
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(6): 3882. CrossRef

A Case of Recurrent Ectopic Parathyroid Adenoma Developed 22 Years after the Initial Parathyroidectomy.: Yoon Jung Kim, Ji A Seo, Ji Mi Moon, Young Jin Seo, Hae Yoon Choi, Hye Sook Kim, Sin Gon Kim, Kyeung mook Choi, Sei Hyun Baik, Dong Seop Choi, Nan Hee Kim; J Korean Endocr Soc. 2009;24(4):260-264. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.260

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Abstract PDF: Persistent or recurrent primary hyperparathyroidism after initial parathyroid surgery occurs at rates of 1.5~10%. A single missed parathyroid adenoma accounts for the majority of persistent hyperparathyroidism, whereas metachronous parathyroid adenoma is a rare cause of recurrent hypercalcemia. We report a case of a 39-year-old female who presented with recurrent pancreatitis. She had symptoms of hyperparathyroidism such as hypercalcemia, hypophosphatemia, hypercalciuria, nephrocalcinosis, and osteoporosis. She had a 2-cm firm neck mass under the right submandibular area. She was diagnosed with primary hyperparathyroidism 22 years ago. At that time, the right upper and lower parathyroid glands were removed after exploration of all parathyroid glands, and a right upper parathyroid adenoma was diagnosed. Now, she had a second surgery to remove the right submandibular mass with intraoperative PTH monitoring, which was diagnosed as a parathyroid adenoma in an ectopic supernumerary parathyroid gland. Because of hungry bone syndrome, she received calcium carbonate replacement therapy and has no evidence of recurrence. Here, we report a recurrent parathyroid adenoma in the undescended, supernumerary parathyroid gland after a long interval from the initial surgery.

A Case of Fulminant Type 1 Diabetes Mellitus Complicated with Ischemic Ileitis.: Se Won Oh, Ju Ri Park, Yun Jeong Lee, Hee Yeong Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim; J Korean Endocr Soc. 2009;24(2):116-120. Published online June 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.2.116

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Abstract PDF: Fulminant type 1 diabetes is characterized by diabetes with an abrupt onset, severe metabolic acidosis at diagnosis, a low HbA1c level and negativity for islet cell-related autoantibodies, and this illness has been classified as type 1B diabetes by the WHO. The prevalence of this disease is higher in Japan than any other country and recently, there have been an increasing number of such case reports in Korea. Genetic factors and environmental factors such as virus infection and an immune mechanism have been suggested as the mechanism of the pathophysiology, but this remains to be clarified.

Normal Repetitive Pregnancies and Tumor Regression Induced by Low-Dose Bromocriptine in a Patient with Macroprolactinoma.: Hye Jung Choi, Jin Yong Park, Woo Seok Choi, Jong Gyu Song, Hee Young Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2009;24(1):42-46. Published online March 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.1.42

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Abstract PDF: Prolactin-secreting adenomas are the most common pituitary tumors. Menstrual disturbances and infertility are the main complaints in women with prolactinoma. Dopaminergic agonists such as bromocriptine are well-established treatments for prolactinoma when pregnancy is desired. Pregnancy-related outcomes in macroprolactinoma are worse than those in microprolactinoma. In addition, symptomatic tumor expansion during pregnancy occurs in 30% of women with macroprolactinoma. Therefore, when women with macroprolactinoma are planning a pregnancy, serum prolactin level should be normalized and the tumor volume significantly reduced. On the other hand, a spontaneous regression of macroprolactinoma can occur after pregnancy. We report a case of macroprolactinoma showing significant tumor regression during repeated pregnancies and low dose bromocriptine treatment, with a literature review.

Two Cases of Acromegaly with Empty Sella Syndrome Treated by Long-Acting Release Octreotide.: Dong Jin Kim, Young Jin Seo, Nam Hoon Kim, Hye Soo Chung, Chai Ryoung Eun, Hye Jung Choi, Hye Sook Kim, Sae Jeong Yang, Juri Park, Hye Jin Yoo, Soo Yeon Park, Yun Jeong Lee, Ohk Hyun Ryu, Kye Won Lee, Hee Young Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2007;22(2):135-141. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.135

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Abstract PDF: Two cases of typical acromegaly with empty sella syndrome presented to our institution. In the natural course of untreated pituitary adenoma, empty sella syndrome may result from necrosis by infarction or from hemorrhage of the pituitary gland. In our patients, the secretion of growth hormone continued in spite of the existence of empty sella syndrome. In one case, we confirmed the hypersecretion of growth hormone from sella by jugular vein sampling. Medical therapy with somatostatin analogue was attempted because there was no obvious mass in the sella. After 6~12 months of treatment with long-acting release octreotide, clinical features in our patients were improved, and the level of growth hormone and IGF-1 were also normalized.

A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus.: Dong Jin Kim, Nan Hee Kim, Ju Ri Park, Sae Jeong Yang, Hye Suk Kim, Hye Jin Yoo, Soo Yeon Park, Ohk Hyun Ryu, Kye Won Lee, Hee Young Kim, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2006;21(4):333-337. Published online August 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.4.333

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Abstract PDF: Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The manifestations of this clinical syndrome are most often caused by a deficiency in the hormones produced by the anterior pituitary gland, whereas the neurohypophysis is usually preserved but can be involved in severe cases that manifest as diabetes insipidus. This is a report of Sheehan's syndrome that manifested with diabetes insipidus as presenting symptom 2 month's after delivery. The patient suffered massive bleeding, so received a blood transfusion. A combined pituitary stimulation and water deprivation test revealed deficiencies of not only anterior pituitary hormones, such as growth hormone and prolactin, but also of anti-diuretic hormone. We report this case, with a review of the literature.

A Case of Primary Hyperparathyroidism Caused by Cystic Parathyroid Adenoma, Diagnosed during Intra-Operative PTH Monitoring.: Hye Jin Yoo, Nan Hee Kim, Soo Yeon Park, Dong Jin Kim, Sae Jeung Yang, Ju Ri Park, Hee Young Kim, Ji A Seo, Kye Won Lee, Sin Gon Kim, Kyung Mook Choi, Jae Bok Lee, Young Seok Lee, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2005;20(3):278-282. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.278

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Abstract PDF: Primary hyperparathyroidism is the most frequent cause of hypercalcemia, and its prevalence is increasing due to the routine examination of serum calcium levels. Primary hyperparathyroidims is most commonly caused by an adenoma or hyperplasia of the parathyroid gland. A cystic parathyroid adenoma is an extremely rare cause of primary hyperparathyroidism. In our case, a-79-year old female presented with lower back pain and constipation. Her serum calcium, phosphate and immunoreactive parathyroid homone levels were 15.6, 1.8mg/dL and 371.8pg/mL, respectively. Neck CT revealed a cystic mass and a contour bulging heterogeneous mass in the left inferior right thyroid gland, respectively. These mass lesions were removed, and the intra-operative parathyroid hormone levels monitored, to confirm the complete resection. After removing the left cystic mass to the inferior thyroid, the serum calcium and immunoreactive parathyroid hormone levels quickly returned to normal. We report a case of primary hyperparathyroidism, caused by a cystic parathyroid adenoma, with a brief review of the literature

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