Endocrinology and Metabolism

Original Articles

Diabetes
Retrospective Analysis of the Efficacy of Dapagliflozin in Patients with Type 2 Diabetes in a Primary Clinic in Korea: Sang Hyun Park, Young Ju Choi, Eun-Jung Rhee, Kab Bum Huh; Endocrinol Metab. 2019;34(1):70-79. Published online March 21, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.1.70

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Background

We aimed to retrospectively analyze the efficacy of 10 mg dapagliflozin (DAPA), which is a sodium-glucose cotransporter-2 inhibitor, in Korean patients with type 2 diabetes who visited a primary diabetes clinic.

Methods

In total, 83 patients with type 2 diabetes, who received treatment with DAPA for the first time in a primary diabetes clinic between January 2015 and October 2015, were included in the study. The effect of DAPA in lowering glycosylated hemoglobin (HbA1c) levels was evaluated via chart review at 6 months follow-up. The patients were categorized into five groups according to add-on to or switched from other glucose-lowering agents: add-on to metformin (MET, n=10), add-on to MET+dipeptidyl peptidase 4 inhibitor (DPP4i, n=12), switched from sulfonylurea (SU, n=13), switched from DPP4i (n=11), and switched from thiazolidinedione (TZD, n=37). All the participants had already used MET for their regimen.

Results

Treatment with DAPA reduced HbA1c level by 1.2%±0.8%. Moreover, a significant decrease was observed in all subgroups: add-on to MET, −1.2%±0.7%; add-on to MET+DPP4i, −1.4%±0.8%; switched from SU, −1.4%±0.7%; switched from DPP4i, −0.5%±0.7%; and switched from TZD, −1.2%±0.9% (P<0.01). A significant decrease in body weight (−3.1±2.6 kg, P<0.001) was observed after DAPA administration. Estimated glomerular filtration rate and urine microalbumin were significantly decreased after 6 months of treatment with DAPA (−4.0±13.5 mL/min/1.73 m², P=0.03; −23.6±45.9 mg/L, P<0.001).

Conclusion

Treatment with DAPA, whether added to or switched from other glucose-lowering agents, significantly decreased HbA1c levels in Korean patients with type 2 diabetes who visited a single primary diabetes clinic. DAPA can be considered as an optimal second-line treatment for patients with type 2 diabetes, as supported by real-world evidence studies.

Citations

Citations to this article as recorded by

The sodium glucose co-transporter 2 inhibitor dapagliflozin ameliorates the fluid-retaining effect of the endothelin A receptor antagonist zibotentan
Vandana Veenit, Hiddo J L Heerspink, Christine Ahlström, Peter J Greasley, Stanko Skritic, Natalie van Zuydam, Donald E Kohan, Pernille B L Hansen, Robert I Menzies
Nephrology Dialysis Transplantation.2023; 38(10): 2289. CrossRef

Endocrine Research
Diastolic Dysfunction Induced by a High-Fat Diet Is Associated with Mitochondrial Abnormality and Adenosine Triphosphate Levels in Rats: Ki-Woon Kang, Ok-Soon Kim, Jung Yeon Chin, Won Ho Kim, Sang Hyun Park, Yu Jeong Choi, Jong Ho Shin, Kyung Tae Jung, Do-Seon Lim, Seong-Kyu Lee; Endocrinol Metab. 2015;30(4):557-568. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.557

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Abstract PDF PubReader

Background

Obesity is well-known as a risk factor for heart failure, including diastolic dysfunction. However, this mechanism in high-fat diet (HFD)-induced obese rats remain controversial. The purpose of this study was to investigate whether cardiac dysfunction develops when rats are fed with a HFD for 10 weeks; additionally, we sought to investigate the association between mitochondrial abnormalities, adenosine triphosphate (ATP) levels and cardiac dysfunction.

Methods

We examined myocardia in Wistar rats after 10 weeks of HFD (45 kcal% fat, n=6) or standard diet (SD, n=6). Echocardiography, histomorphologic analysis, and electron microscopy were performed. The expression levels of mitochondrial oxidative phosphorylation (OXPHOS) subunit genes, peroxisome-proliferator-activated receptor γ co-activator-1α (PGC1α) and anti-oxidant enzymes were assessed. Markers of oxidative stress damage, mitochondrial DNA copy number and myocardial ATP level were also examined.

Results

After 10 weeks, the body weight of the HFD group (349.6±22.7 g) was significantly higher than that of the SD group (286.8±14.9 g), and the perigonadal and epicardial fat weights of the HFD group were significantly higher than that of the SD group. Histomorphologic and electron microscopic images were similar between the two groups. However, in the myocardium of the HFD group, the expression levels of OXPHOS subunit NDUFB5 in complex I and PGC1α, and the mitochondrial DNA copy number were decreased and the oxidative stress damage marker 8-hydroxydeoxyguanosine was increased, accompanied by reduced ATP levels.

Conclusion

Diastolic dysfunction was accompanied by the mitochondrial abnormality and reduced ATP levels in the myocardium of 10 weeks-HFD-induced rats.

Citations

Citations to this article as recorded by

Hippo pathway activated by circulating reactive oxygen species mediates cardiac diastolic dysfunction after acute kidney injury
Xiao Han, Quan Hong, Fei Peng, Yan Zhang, Lingling Wu, Xu Wang, Ying Zheng, Xiangmei Chen
Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2024; : 167184. CrossRef
Epicardial Adipose Tissue in Myocardial Disease: From Physiology to Heart Failure Phenotypes
Alexios S. Antonopoulos, Charalampos Papastamos, Dennis V. Cokkinos, Konstantinos Tsioufis, Dimitris Tousoulis
Current Problems in Cardiology.2023; 48(10): 101841. CrossRef
Metabolic mitochondrial alterations prevail in the female rat heart 8 weeks after exercise cessation
Carolina Tocantins, João D. Martins, Óscar M. Rodrigues, Luís F. Grilo, Mariana S. Diniz, Jelena Stevanovic‐Silva, Jorge Beleza, Pedro Coxito, David Rizo‐Roca, Estela Santos‐Alves, Manoel Rios, Lina Carvalho, António J. Moreno, António Ascensão, José Maga
European Journal of Clinical Investigation.2023;[Epub] CrossRef
The link between obesity and aging - insights into cardiac energy metabolism
Patricia Owesny, Tilman Grune
Mechanisms of Ageing and Development.2023; 216: 111870. CrossRef
Surgically Metabolic Resection of Pericardial Fat to Ameliorate Myocardial Mitochondrial Dysfunction in Acute Myocardial Infarction Obese Rats
Ki-Woon Kang, Ju-Young Ko, Hyunghee Lee, Seung Yong Shin, Wang Soo Lee, Joonhwa Hong, Sang-Wook Kim, Seong-Kyu Lee, Min-Ho Oak
Journal of Korean Medical Science.2022;[Epub] CrossRef
Cilostazol attenuates cardiac oxidative stress and inflammation in hypercholesterolemic rats
Rosane de Oliveira Lopes, Gabriel Ferreira Lima, Ana Beatriz Araújo Mendes, Lis Jappour Autran, Nikolas Cunha de Assis Pereira, Stephani Correia Brazão, Beatriz Alexandre-Santos, Eliete Dalla Corte Frantz, Christianne Brêtas Vieira Scaramello, Fernanda Ca
Naunyn-Schmiedeberg's Archives of Pharmacology.2022; 395(7): 789. CrossRef
The impact of diet upon mitochondrial physiology (Review)
Ioannis Kyriazis, Eleni Vassi, Maria Alvanou, Christos Angelakis, Zoi Skaperda, Fotios Tekos, Venkata Garikipati, Demetrios Spandidos, Demetrios Kouretas
International Journal of Molecular Medicine.2022;[Epub] CrossRef
SIRT1 promotes lipid metabolism and mitochondrial biogenesis in adipocytes and coordinates adipogenesis by targeting key enzymatic pathways
Yasser Majeed, Najeeb Halabi, Aisha Y. Madani, Rudolf Engelke, Aditya M. Bhagwat, Houari Abdesselem, Maha V. Agha, Muneera Vakayil, Raphael Courjaret, Neha Goswami, Hisham Ben Hamidane, Mohamed A. Elrayess, Arash Rafii, Johannes Graumann, Frank Schmidt, N
Scientific Reports.2021;[Epub] CrossRef
Physical Exercise Potentially Targets Epicardial Adipose Tissue to Reduce Cardiovascular Disease Risk in Patients with Metabolic Diseases: Oxidative Stress and Inflammation Emerge as Major Therapeutic Targets
Thembeka A. Nyawo, Carmen Pheiffer, Sithandiwe E. Mazibuko-Mbeje, Sinenhlanhla X. H. Mthembu, Tawanda M. Nyambuya, Bongani B. Nkambule, Hanél Sadie-Van Gijsen, Hans Strijdom, Luca Tiano, Phiwayinkosi V. Dludla
Antioxidants.2021; 10(11): 1758. CrossRef
Potentially Critical Roles ofNDUFB5,TIMMDC1,and VDAC3in the Progression of Septic Cardiomyopathy Through Integrated Bioinformatics Analysis
Kai Kang, Jingtian Li, Ruidong Li, Xiufeng Xu, Jianli Liu, Limin Qin, Tao Huang, Jinhua Wu, Min Jiao, Miaomiao Wei, Hongjie Wang, Tao Wang, Quan Zhang
DNA and Cell Biology.2020; 39(1): 105. CrossRef
Liraglutide shows superior cardiometabolic benefits than lorcaserin in a novel free choice diet-induced obese rat model
François Briand, Emmanuel Brousseau, Julie Maupoint, Caroline Dubroca, Clément Costard, Natalia Breyner, Rémy Burcelin, Thierry Sulpice
European Journal of Pharmacology.2020; 882: 173316. CrossRef
Mitochondrial impairment following neonatal overfeeding: A comparison between normal and ischemic‐reperfused hearts
Cristiane de Moura Freitas, Luciana Caroline Paulino do Nascimento, Glauber Rudá Feitoza Braz, Severina Cassia Andrade‐Silva, Nelson C. Lima‐Junior, Tercya de Araujo Silva, Mariana Pinheiro Fernandes, Diorginis José Soares Ferreira, Claudia Jacques Lagran
Journal of Cellular Biochemistry.2019; 120(5): 7341. CrossRef
Exercise training reverses age‐induced diastolic dysfunction and restores coronary microvascular function
Kazuki Hotta, Bei Chen, Bradley J. Behnke, Payal Ghosh, John N. Stabley, Jeremy A. Bramy, Jaime L. Sepulveda, Michael D. Delp, Judy M. Muller‐Delp
The Journal of Physiology.2017; 595(12): 3703. CrossRef
Qiliqiangxin Enhances Cardiac Glucose Metabolism and Improves Diastolic Function in Spontaneously Hypertensive Rats
Jingfeng Wang, Zhiming Li, Yanyan Wang, Jingjing Zhang, Weipeng Zhao, Mingqiang Fu, Xueting Han, Jingmin Zhou, Junbo Ge
Evidence-Based Complementary and Alternative Medicine.2017; 2017: 1. CrossRef

Case Reports

Ketoacidosis with Hypertriglyceridemia-Induced Pancreatitis in a Patient with Gestational Diabetes: A Case Report.: Hyun Hee Chung, Sang Hyun Park, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee; Endocrinol Metab. 2012;27(1):89-92. Published online March 1, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.1.89

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Abstract PDF

Hypertriglyceridemia-induced acute pancreatitis in pregnancy is not a common complication. Moreover, ketoacidosis in gestational diabetes occurs rarely. Here we report a case of ketoacidosis with hypertriglyceridemia-induced pancreatitis in a patient with gestational diabetes that was successfully treated with insulin and supportive care. In this case, a 36-year-old woman (at 32 weeks' gestation) was diagnosed with gestational diabetes 4 weeks prior, but did not have well controlled blood sugar. She complained of severe epigastric pain concomitant with nausea and vomiting. Radiology and laboratory tests found hypertriglyceridemia (1,996 mg/dL), acute pancreatitis, and ketoacidosis with absence of fetal deceleration on a non-stress test. The patient's condition improved with insulin therapy and fluid replacement. To our knowledge, this is the first report of a case of ketoacidosis with hypertriglyceridemia-induced pancreatitis in a patient with gestational diabetes.

Citations

Citations to this article as recorded by

Acute Pancreatitis in a Pregnant Patient with Type IV Hyperlipoproteinemia
Sang Ho Lee, Jae Hyuck Jun, Young Seok Doh, Ji Woong Jang, Sae Hee Kim, Il Hyun Baek, Sung Hee Jung
The Korean Journal of Pancreas and Biliary Tract.2019; 24(2): 73. CrossRef
Hypertriglyceridemia-Induced Acute Pancreatitis
Jin Myung Park
The Korean Journal of Pancreas and Biliary Tract.2017; 22(4): 158. CrossRef
Cheese-like Material in the Heart: An Autopsy Case Report of Severe Hypertriglyceridemia in Diabetic Ketoacidosis Patient
Joo Young Na, Eun Hee Kim, Bon Young Koo, Ik Jo Chung, Byung Ha Choi, Nak Eun Chung
Korean Journal of Legal Medicine.2013; 37(4): 212. CrossRef

A Case of Neutropenic Enterocolitis Complicating Methimazole-induced Agranulocytosis.: Sang Hyun Park, In Sung Cho, Hyun Jin Kim, Soo Jung Gong, Nae You Kim, Jung Ae Lee; J Korean Endocr Soc. 2007;22(4):282-286. Published online August 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.4.282

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Abstract PDF: Agranulocytosis is a rare complication of antithyroid drug therapy. Neutropenic enterocolitis is characterized by neutropenia plus cecal and ascending colon inflammation, and this is the most feared side effect of agranulocytosis. This is a rare complication of chemotherapy for treating hematological malignancies and less commonly, of the medication used for treating other diseases (e.g., hyperthyroidism). The mortality rate varies from 50 to 100%, with most deaths being due to bowel perforation and sepsis. Therefore, early recognition and proper medical management of neutropenic enterocolitis is important. Recently, early recognition and progress in the management have probably reduced the mortality of this malady, yet there have been no prospective randomized trials or high-quality retrospective studies on the treatment of neutropenic enterocolitis. Therefore, standardized recommendations concerning the indications for surgery cannot be made, but most of these patients are probably not candidates for surgical intervention. Non-surgical management may be a reasonable initial approach for those patients presenting without significant complications such as peritonitis, perforation or bleeding. We report here on a case that was treated with successful medical management for neutropenic enterocolitis that occurred when administering methimazole therapy as an antithyroid drug.

A Case of Hyponatremin Encephalopathy Developed after Transsphenoidal Pituitary Sergery in Menstruant Woman.: Yeo Joo Kim, Mi Rim Kim, Moon Seok Nam, Yong Sung Kim, Jung Bae Jin, Sang Hyun Park, Jun Hong Kang, Sung Bin Hong, Byoung Yun Jun; J Korean Endocr Soc. 1998;13(3):439-445. Published online January 1, 2001

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Abstract PDF: A 41-year-old female complaining of easy fatigue, headache, thickened extremities and deepened facial folds was admitted to the hospital. As early as 6 years ago, she had been told by family members that her voice was changed and both hands was thickened. Cranial plain radiography indicated ballooning of sella turcica. Sella MRI disclosed 2.2cm sized pituitary tumor with suprasellar extension. The pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The postoperative course was uneventful until hyponatremia with sudden headache and respiratory arrest was developed. The case was due to hyponatremic encephalopathy on the basis of the clinical course and symptoms, and 3% hypertonic saline was infused for 12 hours until the hyponatremia was corrected. We have experienced a mortality case of hyponatremic encephalopathy in which surgieal removal of a pituitary tumor from a female acromegalic patient in menstruant period was followed by the sudden occurrence of hyponatremia, which in turn was later associated with marked brain edema.

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