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Review Articles
Calcium & bone metabolism
Cardiovascular Impact of Calcium and Vitamin D Supplements: A Narrative Review
Fatima Zarzour, Ahmad Didi, Mohammed Almohaya, David Kendler
Endocrinol Metab. 2023;38(1):56-68.   Published online February 16, 2023
DOI: https://doi.org/10.3803/EnM.2022.1644
  • 3,550 View
  • 259 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFPubReader   ePub   
Calcium and vitamin D play an important role in mineral homeostasis and the maintenance of skeletal health. Calcium and vitamin D supplements have been widely used for fracture prevention in elderly populations. Many trials have studied the effectiveness and cardiovascular safety of calcium and vitamin D supplementation, with disparate results. In this review, we summarize the most important trials and systematic reviews. There is significant heterogeneity in clinical trial design, differences in the nature of trial outcomes (self-reported vs. verified), prior calcium intake, and trial size. Inconsistent results have been reported concerning the effects of calcium and vitamin D supplementation on cardiovascular outcomes. Most current guidelines recommend calcium intake of up to 1,200 mg daily, preferably from the diet, without concern for cardiovascular risk. Recommendations regarding vitamin D supplementation vary widely. There is compelling evidence from well-conducted randomized trials that modest vitamin D supplementation is safe but does not confer cardiovascular benefit or cardiovascular harm.

Citations

Citations to this article as recorded by  
  • Evaluating adherence, tolerability and safety of oral calcium citrate in elderly osteopenic subjects: a real-life non-interventional, prospective, multicenter study
    Mariangela Rondanelli, Salvatore Minisola, Marco Barale, Daniele Barbaro, Francesca Mansueto, Santina Battaglia, Gloria Bonaccorsi, Santina Caliri, Alessandro Cavioni, Luciano Colangelo, Sabrina Corbetta, Federica Coretti, Giorgia Dito, Valentina Gavioli,
    Aging Clinical and Experimental Research.2024;[Epub]     CrossRef
  • Effect of Denosumab on Bone Density in Postmenopausal Osteoporosis: A Comparison with and without Calcium Supplementation in Patients on Standard Diets in Korea
    Chaiho Jeong, Jinyoung Kim, Jeongmin Lee, Yejee Lim, Dong-Jun Lim, Ki-Hyun Baek, Jeonghoon Ha
    Journal of Clinical Medicine.2023; 12(21): 6904.     CrossRef
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Diabetes, Obesity and Metabolism
Extra-Glycemic Effects of Anti-Diabetic Medications: Two Birds with One Stone?
Eun-Jung Rhee
Endocrinol Metab. 2022;37(3):415-429.   Published online June 29, 2022
DOI: https://doi.org/10.3803/EnM.2022.304
  • 4,279 View
  • 253 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
The world is suffering from a rapid increase in the number of people with diabetes due to the increased prevalence of obesity and lengthened life span. Since the development of insulin thanks to the efforts of Prof. Banting and Dr. Best in 1922, for which they won the Nobel Prize, remarkable developments in anti-diabetic medications have dramatically lengthened the lifespan of patients with diabetes. However, the control rate of hyperglycemia in patients with diabetes remains unsatisfactory, since glycemic control requires both medication and lifestyle modifications to slow the deterioration of pancreatic beta-cell function and prevent diabetic complications. From the initial “triumvirate” to the “ominous octet,” and now the “egregious eleven,” the number of organs recognized as being involved in hyperglycemia and diabetes has increased with the development of anti-diabetic medications. Recent unexpected results from outcome trials of anti-diabetic medications have enabled anti-diabetic medications to be indicated for the prevention of chronic kidney disease and heart failure, even in patients without diabetes. In this review, I would like to summarize the extra-glycemic effects of anti-diabetic medications.

Citations

Citations to this article as recorded by  
  • Association between underweight and risk of heart failure in diabetes patients
    Tae Kyung Yoo, Kyung‐Do Han, Eun‐Jung Rhee, Won‐Young Lee
    Journal of Cachexia, Sarcopenia and Muscle.2024;[Epub]     CrossRef
  • Glucagon-Like Peptide Receptor Agonist Inhibits Angiotensin II-Induced Proliferation and Migration in Vascular Smooth Muscle Cells and Ameliorates Phosphate-Induced Vascular Smooth Muscle Cells Calcification
    Jinmi Lee, Seok-Woo Hong, Min-Jeong Kim, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
    Diabetes & Metabolism Journal.2024; 48(1): 83.     CrossRef
  • To do one and to get more: Part I. Diabetes and bone
    Wen-Ling Lee, Peng-Hui Wang, Szu-Ting Yang, Chia-Hao Liu, Wen-Hsun Chang, Fa-Kung Lee
    Journal of the Chinese Medical Association.2022; 85(10): 965.     CrossRef
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Original Articles
Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Association of High-Density Lipoprotein Cholesterol Phenotypes with the Risk of Cardiovascular Diseases and Mortality: A Cohort Study in Korea
Ga Eun Nam, Youn Huh, Jin-Hyung Jung, Kyungdo Han, Seon Mee Kim, on Behalf of the Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity
Endocrinol Metab. 2022;37(2):261-271.   Published online April 25, 2022
DOI: https://doi.org/10.3803/EnM.2021.1259
  • 3,313 View
  • 137 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We investigated whether low high-density lipoprotein cholesterol (HDL-C) and isolated and non-isolated low HDL-C levels are associated with the risk of cardiovascular diseases and all-cause mortality among Korean adults.
Methods
We included 8,665,841 individuals aged ≥20 years who had undergone a health examination provided by the Korean National Health Insurance Service (NHIS) in 2009 and were followed up until the end of 2018. The hazard ratios (HRs) and 95% confidence intervals (CIs) for study outcomes were calculated using multivariable Cox proportional hazard regression analysis.
Results
During the 8.2 years of mean follow-up, myocardial infarction (MI), stroke, and all-cause mortality occurred in 81,431, 110,996, and 244,309 individuals, respectively. After adjusting for confounding variables (model 3), individuals with low HDL-C and lower HDL quartiles were associated with significantly increased risks of all three outcomes, compared to those with normal HDL-C and highest HDL-C quartile (all P<0.001), respectively. HRs for incident MI (1.28; 95% CI, 1.26 to 1.30), stroke (1.13; 95% CI, 1.11 to 1.15), and all-cause mortality (1.07; 95% CI, 1.05 to 1.08) increased in the non-isolated low HDL-C group compared to the normal HDL-C group. Isolated low HDL-C also showed an increase in the HRs of incident stroke (1.06; 95% CI, 1.04 to 1.08) and all-cause mortality (1.30; 95% CI, 1.28 to 1.32).
Conclusion
Low HDL-C and non-isolated low HDL-C were associated with increased risk of MI, stroke, and all-cause mortality, and isolated low HDL-C was associated with incident stroke and all-cause mortality risk.

Citations

Citations to this article as recorded by  
  • Association of adiposity and fitness with triglyceride-to-high-density lipoprotein cholesterol ratio in youth
    Danladi Ibrahim Musa, Abel Lamina Toriola, Nurudeen O Abubakar, Sunday Omachi, Victor B Olowoleni, Kolade B Ayodele
    Annals of Pediatric Cardiology.2023; 16(3): 194.     CrossRef
  • Association between cholesterol levels and dementia risk according to the presence of diabetes and statin use: a nationwide cohort study
    You-Bin Lee, Min Young Kim, Kyungdo Han, Bongsung Kim, Jiyun Park, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
    Scientific Reports.2022;[Epub]     CrossRef
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Clinical Study
Big Data Articles (National Health Insurance Service Database)
Variabilities in Weight and Waist Circumference and Risk of Myocardial Infarction, Stroke, and Mortality: A Nationwide Cohort Study
Da Hye Kim, Ga Eun Nam, Kyungdo Han, Yang-Hyun Kim, Kye-Yeung Park, Hwan-Sik Hwang, Byoungduck Han, Sung Jung Cho, Seung Jin Jung, Yeo-Joon Yoon, Yong Kyun Roh, Kyung Hwan Cho, Yong Gyu Park
Endocrinol Metab. 2020;35(4):933-942.   Published online December 23, 2020
DOI: https://doi.org/10.3803/EnM.2020.871
  • 5,358 View
  • 108 Download
  • 14 Web of Science
  • 15 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Evidence regarding the association between variabilities in obesity measures and health outcomes is limited. We aimed to examine the association between variabilities in obesity measures and cardiovascular outcomes and all-cause mortality.
Methods
We identified 4,244,460 individuals who underwent health examination conducted by the Korean National Health Insurance Service during 2012, with ≥3 anthropometric measurements between 2009 and 2012. Variabilities in body weight (BW) and waist circumference (WC) were assessed using four indices including variability independent of the mean (VIM). We performed multivariable Cox proportional hazards regression analyses.
Results
During follow-up of 4.4 years, 16,095, 18,957, and 30,200 cases of myocardial infarction (MI), stroke, and all-cause mortality were recorded. Compared to individuals with the lowest quartiles, incrementally higher risks of study outcomes and those of stroke and all-cause mortality were observed among individuals in higher quartiles of VIM for BW and VIM for WC, respectively. The multivariable adjusted hazard ratios and 95% confidence intervals comparing the highest versus lowest quartile groups of VIM for BW were 1.17 (1.12 to 1.22) for MI, 1.20 (1.16 to 1.25) for stroke, and 1.66 (1.60 to 1.71) for all-cause mortality; 1.07 (1.03 to 1.12) for stroke and 1.29 (1.25 to 1.33) for all-cause mortality regarding VIM for WC. These associations were similar with respect to the other indices for variability.
Conclusion
This study revealed positive associations between variabilities in BW and WC and cardiovascular outcomes and allcause mortality. Our findings suggest that variabilities in obesity measures are associated with adverse health outcomes in the general population.

Citations

Citations to this article as recorded by  
  • Weight variability and cardiovascular outcomes: a systematic review and meta-analysis
    Robert J. Massey, Moneeza K. Siddiqui, Ewan R. Pearson, Adem Y. Dawed
    Cardiovascular Diabetology.2023;[Epub]     CrossRef
  • Family history, waist circumference and risk of ischemic stroke: A prospective cohort study among Chinese adults
    Lei Liu, Xiaojia Xue, Hua Zhang, Xiaocao Tian, Yunhui Chen, Yu Guo, Pei Pei, Shaojie Wang, Haiping Duan, Ruqin Gao, Zengchang Pang, Zhengming Chen, Liming Li
    Nutrition, Metabolism and Cardiovascular Diseases.2023; 33(4): 758.     CrossRef
  • Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
    Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
    Endocrinology and Metabolism.2023; 38(1): 10.     CrossRef
  • Weight variability and diabetes complications
    Francesco Prattichizzo, Chiara Frigé, Rosalba La Grotta, Antonio Ceriello
    Diabetes Research and Clinical Practice.2023; 199: 110646.     CrossRef
  • Research on obesity using the National Health Information Database: recent trends
    Eun-Jung Rhee
    Cardiovascular Prevention and Pharmacotherapy.2023; 5(2): 35.     CrossRef
  • Weight cycling and risk of clinical adverse events in patients with heart failure with preserved ejection fraction: a post-hoc analysis of TOPCAT
    Yi Tan, Hang Guo, Ning Zhang, Keyang Zheng, Guifang Liu
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Weight variability, physical functioning and incident disability in older adults
    Katie J. McMenamin, Tamara B. Harris, Joshua F. Baker
    Journal of Cachexia, Sarcopenia and Muscle.2023; 14(4): 1648.     CrossRef
  • Gender differences in midlife to later-life cumulative burden and variability of obesity measures and risk of all-cause and cause-specific mortality
    Karim Kohansal, Siamak Afaghi, Davood Khalili, Danial Molavizadeh, Farzad Hadaegh
    International Journal of Obesity.2023;[Epub]     CrossRef
  • Association between Variability of Metabolic Risk Factors and Cardiometabolic Outcomes
    Min Jeong Park, Kyung Mook Choi
    Diabetes & Metabolism Journal.2022; 46(1): 49.     CrossRef
  • Effects of exercise initiation and smoking cessation after new-onset type 2 diabetes mellitus on risk of mortality and cardiovascular outcomes
    Mee Kyoung Kim, Kyungdo Han, Bongsung Kim, Jinyoung Kim, Hyuk-Sang Kwon
    Scientific Reports.2022;[Epub]     CrossRef
  • Lipid cutoffs for increased cardiovascular disease risk in non-diabetic young people
    Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
    European Journal of Preventive Cardiology.2022; 29(14): 1866.     CrossRef
  • Body Mass Index Is Independently Associated with the Presence of Ischemia in Myocardial Perfusion Imaging
    Chrissa Sioka, Paraskevi Zotou, Michail I. Papafaklis, Aris Bechlioulis, Konstantinos Sakellariou, Aidonis Rammos, Evangelia Gkika, Lampros Lakkas, Sotiria Alexiou, Pavlos Kekiopoulos, Katerina K. Naka, Christos Katsouras
    Medicina.2022; 58(8): 987.     CrossRef
  • Waist Circumference and Body Mass Index Variability and Incident Diabetic Microvascular Complications: A Post Hoc Analysis of ACCORD Trial
    Daniel Nyarko Hukportie, Fu-Rong Li, Rui Zhou, Jia-Zhen Zheng, Xiao-Xiang Wu, Xian-Bo Wu
    Diabetes & Metabolism Journal.2022; 46(5): 767.     CrossRef
  • Nonalcoholic fatty liver disease and the risk of insulin-requiring gestational diabetes
    Sang Youn You, Kyungdo Han, Seung-Hawn Lee, Mee Kyoung Kim
    Diabetology & Metabolic Syndrome.2021;[Epub]     CrossRef
  • Increased Risk of Nonalcoholic Fatty Liver Disease in Individuals with High Weight Variability
    Inha Jung, Dae-Jeong Koo, Mi Yeon Lee, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
    Endocrinology and Metabolism.2021; 36(4): 845.     CrossRef
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Clinical Study
The Association of Overt and Subclinical Hyperthyroidism with the Risk of Cardiovascular Events and Cardiovascular Mortality: Meta-Analysis and Systematic Review of Cohort Studies
Seo Young Sohn, Eunyoung Lee, Min Kyung Lee, Jae Hyuk Lee
Endocrinol Metab. 2020;35(4):786-800.   Published online November 25, 2020
DOI: https://doi.org/10.3803/EnM.2020.728
  • 5,831 View
  • 285 Download
  • 18 Web of Science
  • 21 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Whether hyperthyroidism is an independent risk factor for cardiovascular events remains controversial. We aimed to evaluate the association of overt and subclinical hyperthyroidism with the risk of ischemic heart disease (IHD), stroke, heart failure, and cardiovascular mortality.
Methods
Studies regarding the association between hyperthyroidism and cardiovascular events were searched on PubMed and Embase databases. The cardiovascular disease (CVD) risk was classified as high and low, based on pre-existing diseases, including history of coronary, cerebral, or peripheral artery disease; heart failure; atrial fibrillation; diabetes mellitus; or chronic kidney disease.
Results
Thirty-seven cohort studies were included in this meta-analysis. The pooled hazard ratio for subjects with overt hyperthyroidism compared with the control group was 1.11 (95% confidence interval [CI], 1.03 to 1.19) for IHD, 1.35 (95% CI, 1.03 to 1.75) for stroke, and 1.20 (95% CI, 1.00 to 1.46) for cardiovascular mortality. For subjects with subclinical hyperthyroidism, the pooled hazard ratio was 1.24 (95% CI, 1.07 to 1.45) for IHD, when compared with the control group. Subgroup analysis by CVD risk showed that the risk of stroke in overt hyperthyroidism was increased in the low CVD risk group; however, these association was not observed in the high CVD risk group. Similarly, the risk of IHD in subjects with subclinical hyperthyroidism was significantly increased in the low CVD risk group.
Conclusion
Overt hyperthyroidism is associated with increased risk of IHD, stroke, and cardiovascular mortality, and subclinical hyperthyroidism is associated with increased risk of IHD. These associations were particularly observed in the low risk CVD group without underlying CVD.

Citations

Citations to this article as recorded by  
  • Trends in Prevalence of Thyroid Dysfunction and its Associations With Mortality Among US Participants, 1988-2012
    Xiaowen Zhang, Yong Wang, Hongwei Wang, Xinlin Zhang
    The Journal of Clinical Endocrinology & Metabolism.2024; 109(2): e657.     CrossRef
  • Higher Risk of Incident Hyperthyroidism in Patients With Atrial Fibrillation
    Pang-Shuo Huang, Jen-Fang Cheng, Jien-Jiun Chen, Yi-Chih Wang, Juey-Jen Hwang, Cho-Kai Wu, Chia-Ti Tsai
    The Journal of Clinical Endocrinology & Metabolism.2023; 109(1): 92.     CrossRef
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    Jialin Zheng, Shijian Zhao, Qishi Yang, Yantao Wei, Jianmei Li, Tao Guo
    Critical Reviews in Eukaryotic Gene Expression.2023; 33(5): 17.     CrossRef
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    Matthew D. Ettleson
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    Chang Liu, Zhong Xin, Lin Hua
    Diabetes Research and Clinical Practice.2023; 202: 110811.     CrossRef
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    Sun Y. Lee, Elizabeth N. Pearce
    JAMA.2023; 330(15): 1472.     CrossRef
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    Hyeree Park, Sun Wook Cho, Sung Ho Lee, Kangmin Kim, Hyun-Seung Kang, Jeong Eun Kim, Aesun Shin, Won-Sang Cho
    Thyroid®.2023; 33(12): 1483.     CrossRef
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    Agathoklis Efthymiadis, Matthew Henry, Dimitrios Spinos, Marianthi Bourlaki, Alexandros Tsikopoulos, Angeliki Bourazana, Anastasios Bastounis, Konstantinos Tsikopoulos
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  • Risks of suboptimal and excessive thyroid hormone replacement across ages
    U. Feldt-Rasmussen, G. Effraimidis, S. Bliddal, M. Klose
    Journal of Endocrinological Investigation.2023;[Epub]     CrossRef
  • Association of Mild Thyroid Dysfunction and Adverse Prognosis Among Chinese Patients With Acute ST Segment Elevation Myocardial Infarction
    Mei-Fang Li, Ze-Tao Wei, Shuai Li, Qi-Ming Feng, Jing-Bo Li
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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    Ricardo Correa, Ricardo Villela
    Clinical Thyroidology.2022; 34(6): 240.     CrossRef
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    Zhenqin Cai, Qiyu Chen, Yan Ling, Henrik Falhammar
    International Journal of Endocrinology.2022; 2022: 1.     CrossRef
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    Patrick Müller, Melvin Khee-Shing Leow, Johannes W. Dietrich
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
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    María Laura Barreiro Arcos
    Biochimica et Biophysica Acta (BBA) - General Subjects.2022; 1866(12): 130239.     CrossRef
  • Yearly Incidence of Stroke and Bleeding in Atrial Fibrillation with Concomitant Hyperthyroidism: A National Discharge Database Study
    Juqian Zhang, Arnaud Bisson, Grégoire Fauchier, Alexandre Bodin, Julien Herbert, Pierre Henri Ducluzeau, Gregory Y. H. Lip, Laurent Fauchier
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    Yu-tian Cao, Kai-yu Zhang, Jing Sun, Yan Lou, Tian-su Lv, Xinyi Yang, Wen-hui Zhang, Jiang-yi Yu, Qi-biao Wu, Xi-qiao Zhou
    Frontiers in Immunology.2022;[Epub]     CrossRef
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    Karen Tsai, Angela M. Leung
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    G. Corona, L. Croce, C. Sparano, L. Petrone, A. Sforza, M. Maggi, L. Chiovato, M. Rotondi
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    Jae Hoon Chung
    Endocrinology and Metabolism.2021; 36(3): 491.     CrossRef
  • Cardiovascular Outcomes in Thyroid Cancer Patients Treated With Thyroidectomy: A Meta-Analysis
    Eun Kyung Lee, Hwa Young Ahn, Eu Jeong Ku, Won Sang Yoo, Young Ki Lee, Kee-Hyun Nam, Young Jun Chai, Shinje Moon, Yuh-Seog Jung
    The Journal of Clinical Endocrinology & Metabolism.2021;[Epub]     CrossRef
Close layer
Review Article
Adrenal gland
Primary Aldosteronism and Cerebrovascular Diseases
Zheng-Wei Chen, Chi-Sheng Hung, Vin-Cent Wu, Yen-Hung Lin
Endocrinol Metab. 2018;33(4):429-434.   Published online November 30, 2018
DOI: https://doi.org/10.3803/EnM.2018.33.4.429
  • 4,750 View
  • 65 Download
  • 20 Web of Science
  • 19 Crossref
AbstractAbstract PDFPubReader   ePub   

As diagnostic techniques have advanced, primary aldosteronism (PA) has emerged as the most common cause of secondary hypertension. The excess of aldosterone caused by PA resulted in not only cardiovascular complications, including coronary artery disease, myocardial infarction, arrhythmia, and heart failure, but also cerebrovascular complications, such as stroke and transient ischemic attack. Moreover, PA is associated more closely with these conditions than is essential hypertension. In this review, we present up-to-date findings on the association between PA and cerebrovascular diseases.

Citations

Citations to this article as recorded by  
  • Cardiovascular and metabolic characters of KCNJ5 somatic mutations in primary aldosteronism
    Yi-Yao Chang, Bo-Ching Lee, Zheng-Wei Chen, Cheng-Hsuan Tsai, Chin-Chen Chang, Che-Wei Liao, Chien-Ting Pan, Kang-Yung Peng, Chia-Hung Chou, Ching-Chu Lu, Vin-Cent Wu, Chi-Sheng Hung, Yen-Hung Lin
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    Igor Hartmann, Frantisek Hruska, Jan Vaclavik, Eva Kocianova, Zdenek Frysak, Marika Nesvadbova, Zbynek Tudos, Filip Ctvrtlik, Klara Benesova
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    The Journal of Clinical Endocrinology & Metabolism.2022;[Epub]     CrossRef
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    Hypertension.2021; 77(6): 1964.     CrossRef
  • Pearls & Oy-sters: Cerebral Microbleeds Caused by Adrenocortical Adenoma-Related Primary Aldosteronism
    Sun Min Lee, Yong Jun Choi, Kihwang Lee, Hyeung Kyoo Kim, Jin-Sun Park, Yong Cheol Lim, Jang-Hee Kim, So Young Moon
    Neurology.2021; 96(20): 960.     CrossRef
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    Jacopo Pieroni, Yuto Yamazaki, Xin Gao, Yuta Tezuka, Hiroko Ogata, Kei Omata, Yoshikiyo Ono, Ryo Morimoto, Yasuhiro Nakamura, Fumitoshi Satoh, Hironobu Sasano
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    Ye Seul Yang, Seung Hun Lee, Jung Hee Kim, Jee Hee Yoo, Jung Hyun Lee, Seo Young Lee, A Ram Hong, Dong-Hwa Lee, Jung-Min Koh, Jae Hyeon Kim, Sang Wan Kim
    Endocrinology and Metabolism.2021; 36(4): 875.     CrossRef
  • Aldosterone Inhibits In Vitro Myogenesis by Increasing Intracellular Oxidative Stress via Mineralocorticoid Receptor
    Jin Young Lee, Da Ae Kim, Eunah Choi, Yun Sun Lee, So Jeong Park, Beom-Jun Kim
    Endocrinology and Metabolism.2021; 36(4): 865.     CrossRef
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Original Articles
Obesity and Metabolism
Comparison of the Effects of Ezetimibe-Statin Combination Therapy on Major Adverse Cardiovascular Events in Patients with and without Diabetes: A Meta-Analysis
Namki Hong, Yong-ho Lee, Kenichi Tsujita, Jorge A. Gonzalez, Christopher M. Kramer, Tomas Kovarnik, George N. Kouvelos, Hiromichi Suzuki, Kyungdo Han, Chan Joo Lee, Sung Ha Park, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang
Endocrinol Metab. 2018;33(2):219-227.   Published online May 4, 2018
DOI: https://doi.org/10.3803/EnM.2018.33.2.219
  • 5,516 View
  • 120 Download
  • 18 Web of Science
  • 17 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Ezetimibe-statin combination therapy has been found to reduce low density lipoprotein cholesterol levels and the risk of major adverse cardiovascular events (MACEs) in large trials. We sought to examine the differential effect of ezetimibe on MACEs when added to statins according to the presence of diabetes.

Methods

Randomized clinical trials with a sample size of at least 50 participants and at least 24 weeks of follow-up that compared ezetimibe-statin combination therapy with a statin- or placebo-controlled arm and reported at least one MACE, stratified by diabetes status, were included in the meta-analysis and meta-regression.

Results

A total of seven trials with 28,191 enrolled patients (mean age, 63.6 years; 75.1% men; 7,298 with diabetes [25.9%]; mean follow-up, 5 years) were analysed. MACEs stratified by diabetes were obtained from the published data (two trials) or through direct contact (five trials). No significant heterogeneity was observed among studies (I2=14.7%, P=0.293). Ezetimibe was associated with a greater reduction of MACE risk in subjects with diabetes than in those without diabetes (pooled relative risk, 0.84 vs. 0.93; Pheterogeneity=0.012). In the meta-regression analysis, the presence of diabetes was associated with a greater reduction of MACE risk when ezetimibe was added to statins (β=0.87, P=0.038).

Conclusion

Ezetimibe-statin combination therapy was associated with greater cardiovascular benefits in patients with diabetes than in those without diabetes. Our findings suggest that ezetimibe-statin combination therapy might be a useful strategy in patients with diabetes at a residual risk of MACEs.

Citations

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    Journal of Atherosclerosis and Thrombosis.2023; 30(11): 1580.     CrossRef
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Obesity and Metabolism
Sex Factors in the Metabolic Syndrome as a Predictor of Cardiovascular Disease
Sunghwan Suh, Jongha Baek, Ji Cheol Bae, Kyoung-Nyoun Kim, Mi Kyoung Park, Duk Kyu Kim, Nam H. Cho, Moon-Kyu Lee
Endocrinol Metab. 2014;29(4):522-529.   Published online December 29, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.4.522
  • 4,527 View
  • 37 Download
  • 16 Web of Science
  • 17 Crossref
AbstractAbstract PDFPubReader   
Background

Metabolic syndrome (MetS) is a condition characterized by a cluster of metabolic disorders and is associated with increased risk of cardiovascular disease (CVD). This study analyzed data from the Korean Health and Genome Study to examine the impact of MetS on CVD.

Methods

A total of 8,898 subjects (4,241 males and 4,657 females), 40 to 69 years of age, were enrolled and evaluated for the development of new onset CVD from 2001 to 2012 (median 8.1 years of follow-up).

Results

The prevalence of MetS at baseline was 22.0% (932/4,241) and 29.7% (1,383/4,657) in males and females, respectively. MetS was associated with increased risk of coronary heart disease (CHD; hazard ratio [HR], 1.818; 95% confidence interval [CI], 1.312 to 2.520 in males; HR, 1.789; 95% CI, 1.332 to 2.404 in females) and CVD (HR, 1.689; 95% CI, 1.295 to 2.204 in males; HR, 1.686; 95% CI, 1.007 to 2.192 in females). Specifically, MetS was associated with risk of future stroke in females only (HR, 1.486; 95% CI, 1.007 to 2.192). Among MetS components, abdominal obesity and hypertension were independent predictors of both CHD and CVD. In addition, a higher number of MetS components correlated with higher CVD risk.

Conclusion

MetS is a significant risk factor for the development of CVD although its impact varies between sexes.

Citations

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Endocrinol Metab : Endocrinology and Metabolism