Endocrinology and Metabolism

Original Article

Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP): Jae Hoon Moon, Eun Kyung Lee, Wonjae Cha, Young Jun Chai, Sun Wook Cho, June Young Choi, Sung Yong Choi, A Jung Chu, Eun-Jae Chung, Yul Hwangbo, Woo-Jin Jeong, Yuh-Seog Jung, Kyungsik Kim, Min Joo Kim, Su-jin Kim, Woochul Kim, Yoo Hyung Kim, Chang Yoon Lee, Ji Ye Lee, Kyu Eun Lee, Young Ki Lee, Hunjong Lim, Do Joon Park, Sue K. Park, Chang Hwan Ryu, Junsun Ryu, Jungirl Seok, Young Shin Song, Ka Hee Yi, Hyeong Won Yu, Eleanor White, Katerina Mastrocostas, Roderick J. Clifton-Bligh, Anthony Glover, Matti L. Gild, Ji-hoon Kim, Young Joo Park; Received August 9, 2024 Accepted November 29, 2024 Published online February 18, 2025; DOI: https://doi.org/10.3803/EnM.2024.2136 [Epub ahead of print]

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Abstract PDF Supplementary Material PubReader ePub: Background
Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making.
Methods
This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes.
Conclusion
This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Review Articles

Diabetes, obesity and metabolism
Epidemiology and Trends of Obesity and Bariatric Surgery in Korea: Kyungdo Han, Jin-Hyung Jung, Su-Min Jeong, Mee Kyoung Kim; Endocrinol Metab. 2024;39(5):678-685. Published online August 2, 2024; DOI: https://doi.org/10.3803/EnM.2024.2056

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The prevalence of obesity in Korea has steadily increased over the past decade, reaching 38.4% in 2021. Notably, the rate of class II– III obesity, defined as a body mass index (BMI) of 30 kg/m² or higher, exceeded 7% in the same year. Since January 2019, the National Health Insurance Service (NHIS) has provided coverage for bariatric surgery (BS) for eligible patients. Coverage is available for individuals with a BMI of 35 kg/m² or higher, or those with a BMI of 30 kg/m² or higher who also have obesity-related comorbidities. Additionally, partial reimbursement is offered for BS in patients with type 2 diabetes mellitus who have BMI values between 27.5 and 30 kg/m². From 2019 to 2022, the NHIS recorded 9,080 BS procedures, with sleeve gastrectomy being the most commonly performed. The average percentage of weight loss 198±99.7 days post-surgery was 17.9%, with 80.0% of patients losing more than 10% of their body weight. This article presents the trends in obesity and BS in Korea.

Citations

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Impact of caloric restriction on diabetes remission in Korean adults with obesity (CREDO‐K study)
Mee Kyoung Kim, Jinyoung Kim, Su‐Jeong Park, Yoon‐Ju Song, Hyuk‐Sang Kwon
Diabetes, Obesity and Metabolism.2025; 27(3): 1609. CrossRef

Diabetes, obesity and metabolism
Regulation of Energy and Glucose Homeostasis by the Nucleus of the Solitary Tract and the Area Postrema: Kyla Bruce, Ameth N. Garrido, Song-Yang Zhang, Tony K.T. Lam; Endocrinol Metab. 2024;39(4):559-568. Published online August 1, 2024; DOI: https://doi.org/10.3803/EnM.2024.2025

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The central nervous system regulates feeding, weight and glucose homeostasis in rodents and humans, but the site-specific mechanisms remain unclear. The dorsal vagal complex in the brainstem that contains the nucleus of the solitary tract (NTS) and area postrema (AP) emerges as a regulatory center that impacts energy and glucose balance by monitoring hormonal and nutrient changes. However, the specific mechanistic metabolic roles of the NTS and AP remain elusive. This mini-review highlights methods to study their distinct roles and recent findings on their metabolic differences and similarities of growth differentiation factor 15 (GDF15) action and glucose sensing in the NTS and AP. In summary, future research aims to characterize hormonal and glucose sensing mechanisms in the AP and/or NTS carries potential to unveil novel targets that lower weight and glucose levels in obesity and diabetes.

Citations

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Brain circadian clocks timing the 24h rhythms of behavior
Jorge Mendoza
npj Biological Timing and Sleep.2025;[Epub] CrossRef
Hypothalamus and brainstem circuits in the regulation of glucose homeostasis
Zitian Lin, Yunxin Xuan, Yingshi Zhang, Qirui Zhou, Weiwei Qiu
American Journal of Physiology-Endocrinology and Metabolism.2025; 328(4): E588. CrossRef

Original Article

Hypothalamus and pituitary gland
Obstructive Sleep Apnea Screening and Effects of Surgery in Acromegaly: A Prospective Study: Jaeyoung Cho, Jung Hee Kim, Yong Hwy Kim, Jinwoo Lee; Endocrinol Metab. 2024;39(4):641-652. Published online June 26, 2024; DOI: https://doi.org/10.3803/EnM.2024.1933

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Background
To identify a screening tool for obstructive sleep apnea (OSA) and evaluate the effects of endoscopic transsphenoidal surgery on improving OSA in patients with acromegaly.
Methods
We prospectively enrolled adults with acromegaly scheduled for endoscopic transsphenoidal surgery. All measurements were conducted when participants were admitted for a baseline work-up for acromegaly before surgery and surveillance approximately 3 to 6 months after surgery. Respiratory event index (REI) was used as a surrogate for apnea-hypopnea index (Trial Registration: NCT03526016).
Results
Of the 35 patients with acromegaly (median age, 47 years; 40% men; median body mass index, 24.4 kg/m²), 24 (68.6%) had OSA (REI ≥5/hour), 15 (42.9%) had moderate-to-severe OSA (REI ≥15/hour). At baseline, serum insulin-like growth factor 1 (IGF-1) levels were positively correlated with the REI (ρ=0.53, P=0.001). The sensitivity and negative predictive value of a Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, age, Neck circumference, and Gender (STOP-Bang) score ≥ 3 were 93.3% and 87.5%, respectively, detecting moderate-to-severe OSA. Biochemical acromegaly remission was achieved in 32 (91.4%) patients. The median difference in the REI was –9.5/hour (95% confidence interval, –13.3 to –5.3). Half of the 24 patients diagnosed with OSA preoperatively had REI <5/hour postoperatively. In a linear mixed-effects model, changes in the REI across surgery were related to changes in IGF-1 levels.
Conclusion
The STOP-Bang questionnaire is a reliable tool for OSA among patients with acromegaly. Improvement in OSA severity after surgery is related to decreased IGF-1 levels.

Citations

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Long-Term Prognosis and Systemic Impact of Acromegaly: Analyses Utilizing Korean National Health Insurance Data
Sangmo Hong, Kyungdo Han, Cheol-Young Park
Endocrinology and Metabolism.2025; 40(1): 1. CrossRef
How Different Treatments for Acromegaly Modulate Sleep Quality: A Psychometric Study
Gaspare Alfì, Danilo Menicucci, Dalì Antonia Ciampa, Vito Di Giura, Giulia Marconcini, Claudio Urbani, Fausto Bogazzi, Angelo Gemignani
Endocrines.2024; 5(3): 408. CrossRef

Review Article

Hypothalamus and pituitary gland
Update on Current Evidence for the Diagnosis and Management of Nonfunctioning Pituitary Neuroendocrine Tumors: Elizabeth Whyte, Masahiro Nezu, Constance Chik, Toru Tateno; Endocrinol Metab. 2023;38(6):631-654. Published online November 15, 2023; DOI: https://doi.org/10.3803/EnM.2023.1838

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Pituitary neuroendocrine tumors (PitNETs) are the third most frequently diagnosed intracranial tumors, with nonfunctioning PitNETs (nfPitNETs) accounting for 30% of all pituitary tumors and representing the most common type of macroPitNETs. NfPitNETs are usually benign tumors with no evidence of hormone oversecretion except for hyperprolactinemia secondary to pituitary stalk compression. Due to this, they do not typically present with clinical syndromes like acromegaly, Cushing’s disease or hyperthyroidism and instead are identified incidentally on imaging or from symptoms of mass effects (headache, vision changes, apoplexy). With the lack of effective medical interventions, first-line treatment is transsphenoidal surgical resection, however, nfPitNETs often have supra- or parasellar extension, and total resection of the tumor is often not possible, resulting in residual tumor regrowth or reoccurrence. While functional PitNETs can be easily followed for recurrence using hormonal biomarkers, there is no similar parameter to predict recurrence in nfPitNETs, hence delaying early recognition and timely management. Therefore, there is a need to identify prognostic biomarkers that can be used for patient surveillance and as therapeutic targets. This review focuses on summarizing the current evidence on nfPitNETs, with a special focus on potential new biomarkers and therapeutics.

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Circulating miR-20a-5p as a biomarker associated with cabergoline responsiveness in patients with hyperprolactinemia and pituitary adenomas
Yang Jong Lee, Jae Won Hong, Yongjae Kim, Jisup Kim, Chan Woo Kang, Min-Ho Lee, Ju Hyung Moon, Eui Hyun Kim, Cheol Ryong Ku, Eun Jig Lee
European Journal of Endocrinology.2025; 192(4): 335. CrossRef
Phenotype Transformation of PitNETs
Zhenwei Li, Yinzi Wu, Guannan He, Renzhi Wang, Xinjie Bao
Cancers.2024; 16(9): 1731. CrossRef
Donor–Acceptor–Donor Strategy Rouses the Photodynamic Therapy Anticancer Activity of a Bis-terpyridyl Ru(II) Complex
Zhongyu Wang, Li Wei, Junfeng Lin, Can Huang, Huitong Chen, Dong Fan, Weiyu Hu, Jing Liu, Huaiyi Huang, Zongming Wang, Xin Wang
Journal of Medicinal Chemistry.2024; 67(15): 13435. CrossRef
A Study in Pituitary Neuroendocrine Tumors (PitNETs): Real-Life Data Amid Baseline and Serial CT Scans
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Editorial: Prognostic factors in pituitary tumors: clinical, biochemical, imaging, and pathological aspects
Toru Tateno, Roxana-Ioana Dumitriu Stan, Stephanie Du Four
Frontiers in Endocrinology.2024;[Epub] CrossRef
Adaptive evaluation of gross total resection rates for endoscopic endonasal approach based on preoperative MRI morphological features of pituitary adenomas
Ao Shen, Yue Min, Dongjie Zhou, Lirui Dai, Liang Lyu, Wenyi Zhan, Shu Jiang, Peizhi Zhou
Frontiers in Oncology.2024;[Epub] CrossRef

Original Article

Diabetes, Obesity and Metabolism
Association between the Blautia/Bacteroides Ratio and Altered Body Mass Index after Bariatric Surgery: Yoonhong Kim, Dooheon Son, Bu Kyung Kim, Ki Hyun Kim, Kyung Won Seo, Kyoungwon Jung, Seun Ja Park, Sanghyun Lim, Jae Hyun Kim; Endocrinol Metab. 2022;37(3):475-486. Published online June 29, 2022; DOI: https://doi.org/10.3803/EnM.2022.1481; Correction in: Endocrinol Metab 2022;37(4):701

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Background
Current evidence support that the gut microbiota plays a potential role in obesity. Bariatric surgery can reduce excess weight and decrease the risk of life-threatening weight-related health problems and may also influence gut microbiota. In this study, we aimed to investigate the changes in gut microbiota before and after bariatric surgery and evaluate the association of the gut microbial shift and altered body mass index (BMI) after bariatric surgery.
Methods
Between January 2019 and July 2020, stools from 58 patients scheduled for bariatric surgery were collected. Six months after bariatric surgery, stools from 22 of these patients were re-collected, and the changes in gut microbiota before and after bariatric surgery were evaluated. In addition, the differences in gut microbiota between patients with severe obesity (BMI >35 kg/m², n=42) and healthy volunteers with normal BMI (18.8 to 22.8 kg/m², n=41) were investigated.
Results
The gut microbiota of patients who underwent bariatric surgery showed increased α-diversity and differed β-diversity compared with those before surgery. Interestingly, Blautia was decreased and Bacteriodes was increased at the genus level after bariatric surgery. Further, the Blautia/Bacteroides ratio showed a positive correlation with BMI. To validate these results, we compared the gut microbiota from severely obese patients with high BMI with those from healthy volunteers and demonstrated that the Blautia/Bacteroides ratio correlated positively with BMI.
Conclusion
In the gut microbial analysis of patients who underwent bariatric surgery, we presented that the Blautia/Bacteroides ratio had changed after bariatric surgery and showed a positive correlation with BMI.

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Review Articles

Bone Metabolism
Normocalcemic Primary Hyperparathyroidism: Need for a Standardized Clinical Approach: Guido Zavatta, Bart L. Clarke; Endocrinol Metab. 2021;36(3):525-535. Published online June 1, 2021; DOI: https://doi.org/10.3803/EnM.2021.1061

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Since normocalcemic primary hyperparathyroidism (NHPT) was first defined at the Third International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism in 2008, many papers have been published describing its prevalence and possible complications. Guidelines for the management of this condition are still lacking, and making the diagnosis requires fulfillment of strict criteria. Recent studies have shown that intermittent oscillations of serum calcium just below and slightly above the normal limits are very frequent, therefore challenging the assumption that serum calcium must be consistently normal to make the diagnosis. There is debate if these variations in serum calcium outside the normal range should be included under the rubric of NHPT or, rather, a milder form of classical primary hyperparathyroidism. Innovative approaches to define NHPT have been proposed that still need to be validated in prospective studies. Non-classical complications, especially cardiovascular complications, have been associated with NHPT, indicating that hyperparathyroidism may be a cardiovascular risk factor. New associations between parathyroid hormone (PTH) and several other comorbidities have also been reported from observational studies, suggesting that excessive PTH secretion might cause tissue dysfunction independent of serum calcium. Heterogeneous studies using different definitions of NHPT, however, make it difficult to draw definitive conclusions regarding the role of PTH excess when complications other than osteoporosis or kidney stones are described. This review will focus on clinical aspects and suggest an approach to NHPT.

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Dietary calcium intake in primary hyperparathyroidism and in its normocalcemic variant: a case-control study
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Frontiers in Endocrinology.2025;[Epub] CrossRef
Surgery for Normocalcemic Hyperparathyroidism
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10 Years Prospective Study for the Surgical Total Removal of Pituitary Tumor; Preliminary Report - 2, 5 Years Follow Up.: Eun Jig Lee, Sung Kil Lim, Kap Bum Huh, Sun Ho Kim, Dong Ik Kim, Byung Hee Lee, Ju Heon Yoon, Su Yeon Choi, Joong Uhn Choi, Sang Seop Chung, Kyu Chang Lee; J Korean Endocr Soc. 1994;10(2):85-94. Published online November 6, 2019

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Abstract PDF: The goal of the pituitary tumor surgery is restoration of the normal endocrine function and releaving the pressure effects of the tumor mass on the adjacent neural structures. The authors had proceeded with the 10 years prospective follow-up study for the endocrine function and recurrence of pituitary tumor in the patients who received the complete total resection of tumor mass by the means of total capsulectomy.The authors will discuss the preliminary result of 2.5 years follow-up of this study.

Original Article

Clinical Study
Factors Associated with Postoperative Diabetes Insipidus after Pituitary Surgery: Antonio L. Faltado, Anna Angelica Macalalad-Josue, Ralph Jason S. Li, John Paul M. Quisumbing, Marc Gregory Y. Yu, Cecilia A. Jimeno; Endocrinol Metab. 2017;32(4):426-433. Published online November 21, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.4.426

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Background

Determining risk factors for diabetes insipidus (DI) after pituitary surgery is important in improving patient care. Our objective is to determine the factors associated with DI after pituitary surgery.

Methods

We reviewed records of patients who underwent pituitary surgery from 2011 to 2015 at Philippine General Hospital. Patients with preoperative DI were excluded. Multiple logistic regression analysis was performed and a predictive model was generated. The discrimination abilities of the predictive model and individual variables were assessed using the receiving operator characteristic curve.

Results

A total of 230 patients were included. The rate of postoperative DI was 27.8%. Percent change in serum Na (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.15 to 1.69); preoperative serum Na (OR, 1.19; 95% CI, 1.02 to 1.40); and performance of craniotomy (OR, 5.48; 95% CI, 1.60 to 18.80) remained significantly associated with an increased incidence of postoperative DI, while percent change in urine specific gravity (USG) (OR, 0.53; 95% CI, 0.33 to 0.87) and meningioma on histopathology (OR, 0.05; 95% CI, 0.04 to 0.70) were significantly associated with a decreased incidence. The predictive model generated has good diagnostic accuracy in predicting postoperative DI with an area under curve of 0.83.

Conclusion

Greater percent change in serum Na, preoperative serum Na, and performance of craniotomy significantly increased the likelihood of postoperative DI while percent change in USG and meningioma on histopathology were significantly associated with a decreased incidence. The predictive model can be used to generate a scoring system in estimating the risk of postoperative DI.

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Lei Shi, Yu-Fang Wang, Guo-Feng Zhang, Yan Li, Ming-Li Yao, Jing-Chao Li, Chun-Fang Qiu, Shun Yao, Bin Ouyang, Ling-Yan Wang
Neurosurgical Review.2025;[Epub] CrossRef
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In Reply to the Letter to the Editor Regarding “Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study”
Marcos Ezequiel Yasuda, Daniela Renedo, Rodolfo Recalde, Roberto Zaninovich, Santiago Gonzalez Abbati, Andrés Cervio, Sebastian Giovannini, Juan Villalonga, Liezel Ulloque-Caamaño, Kesava Reddy, Mariano Socolovsky, Alvaro Campero
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Letter to the Editor Regarding “Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study”
Karlos Acurio, Fritz Fidel Váscones-Román, Fernando Canazas-Paredes, Aryan Wadhwa, Niels Pacheco-Barrios
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Neurosurgery.2023; 92(6): 1269. CrossRef
Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study
Marcos Ezequiel Yasuda, Daniela Renedo, Soledad Sosa, Karina Danilowicz, Rodolfo Recalde, Roberto Zaninovich, Santiago Gonzalez Abbati, Andrés Cervio, Sebastian Giovannini, Juan Villalonga, Liezel Ulloque-Caamaño, Kesava Reddy, Mariano Socolovsky, Alvaro
World Neurosurgery.2023; 175: e636. CrossRef
Change in cephalocaudal tumor cavity diameter after transsphenoidal surgery is a predictor of diabetes insipidus in pituitary adenoma
Kunzhe Lin, Kaichun Fan, Shuwen Mu, Shousen Wang
European Journal of Medical Research.2022;[Epub] CrossRef
Change in the pituitary stalk deviation angle after transsphenoidal surgery can predict the development of diabetes insipidus for pituitary adenomas
Liang Xue, Jianwu Wu, Jie Chen, Yongkai Yang
Endocrine Connections.2022;[Epub] CrossRef
Disorders of Salt and Water Balance After Pituitary Surgery
Emily K Brooks, Warrick J Inder
The Journal of Clinical Endocrinology & Metabolism.2022; 108(1): 198. CrossRef
Postoperative diabetes insipidus: how to define and grade this complication?
Friso de Vries, Daniel J. Lobatto, Marco J. T. Verstegen, Wouter R. van Furth, Alberto M. Pereira, Nienke R. Biermasz
Pituitary.2021; 24(2): 284. CrossRef
Diaphragma sellae sinking can predict the onset of hyponatremia after transsphenoidal surgery for pituitary adenomas
Kunzhe Lin, Jun Li, Lingling Lu, Shangming Zhang, Shuwen Mu, Zhijie Pei, Cheng Wang, Jingying Lin, Liang Xue, Liangfeng Wei, Lin Zhao, Shousen Wang
Journal of Endocrinological Investigation.2021; 44(11): 2511. CrossRef
Adrenocorticotropic Hormone-Secreting Pituitary Macroadenoma
Ujjwala Murkute
Indian Journal of Continuing Nursing Education.2021; 22(2): 137. CrossRef
Sodium Perturbations After Pituitary Surgery
Kevin C.J. Yuen, Adnan Ajmal, Ricardo Correa, Andrew S. Little
Neurosurgery Clinics of North America.2019; 30(4): 515. CrossRef

Review Articles

Metabolic Surgery in Korea: What to Consider before Surgery: Mi-Kyung Kim, Yoonseok Heo; Endocrinol Metab. 2017;32(3):307-315. Published online September 18, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.3.307

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Obesity is increasing globally and represents a significant global health problem because it predisposes towards various diseases, such as type 2 diabetes mellitus, cardiovascular disease, degenerative joint disease, and certain types of cancer. Numerous studies have shown that bariatric surgery reduces body mass and ameliorates obesity-related complications, such as hypertension and hyperglycemia, suggesting that surgery is the most effective therapeutic option for severely obese and obese diabetic patients. Recent international guidelines recommend surgical treatment for diabetic patients with class III obesity (body mass index [BMI] >40 kg/m²), regardless of their level of glycemic control or the complexity of their glucose-lowering regimens, and for patients with class II obesity (BMI 35.0 to 39.9 kg/m²) and hyperglycemia that is poorly controlled despite appropriate lifestyle and pharmacological therapy. The most popular procedures are Roux-en-Y gastric bypass and sleeve gastrectomy, but new procedures with better outcomes have been reported. For optimal surgical outcome, comprehensive management including assessments of a medical condition, nutrition, mental health, and social support is needed before and after surgery. However, there is still a lack of understanding regarding metabolic surgery in Korea. Therefore, this article reviews indications for metabolic surgery in patients with a specific focus on the situation in Korea.

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Relationship between peak expiratory flow and impaired functional capacity in obese individuals
Graziele Mayra Santos Moreira, Angela Maria Ribeiro, Patrícia Maria de Melo Carvalho, Pedro Augusto de Carvalho Mira, Isabelle Magalhães Guedes Freitas
Fisioterapia em Movimento.2021;[Epub] CrossRef

Obesity and Metabolism
Current Status of Bariatric and Metabolic Surgery in Korea: Youn-Baik Choi; Endocrinol Metab. 2016;31(4):525-532. Published online November 4, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.4.525

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Bariatric surgery is considered to be the most effective treatment modality in maintaining long-term weight reduction and improving obesity-related conditions in morbidly obese patients. In Korea, surgery for morbid obesity was laparoscopic sleeve gastrectomy first performed in 2003. Since 2003, the annual number of bariatric surgeries has markedly increased, including adjustable gastric banding (AGB), Roux-en-Y gastric bypass, sleeve gastrectomy, mini-gastric bypass, and others. In Korea, AGB is much more common than in others countries. A large proportion of doctors, the public, and government misunderstand the necessity and effectiveness of bariatric surgery, believing that bariatric surgery has an unacceptably high morbidity, and that it is not superior to non-surgical treatments to improve obesity and obesity-related diseases. The effectiveness, safety, and cost-effectiveness of bariatric surgery have been well demonstrated. The Korean Society of Metabolic and Bariatric Surgery recommend bariatric surgery confining to morbidly obese patients (body mass index ≥40 or >35 in the presence of significant comorbidities).

Citations

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Comparison of Eastern and Western patients undergoing bariatric surgery at two US and Korean institutions: a retrospective analysis of differing bariatric patient populations
Zachary N. Weitzner, Ki Hyun Kim, Yoonhong Kim, Kyung Won Seo, Young Sik Choi, Erik P. Dutson
Surgical Endoscopy.2024; 38(1): 129. CrossRef
Survey of Information Acquisition and Satisfaction after Bariatric Surgery at a Tertiary Hospital in Korea
Seul-Gi Oh, Seong-A Jeong, Chang Seok Ko, Sa-Hong Min, Chung Sik Gong, In-Seob Lee, Beom Su Kim, Jeong Hwan Yook, Moon-Won Yoo
Journal of Obesity & Metabolic Syndrome.2024; 33(1): 45. CrossRef
Surgical outcomes of laparoscopic sleeve gastrectomy by a single surgeon: Before and after learning curve in a non-tertiary low-volume bariatric center
Sungbae Lee, Seongpyo Mun
Asian Journal of Surgery.2023; 46(11): 4755. CrossRef
Weight Loss Experience of Highly Obese Young Adult Who Underwent Bariatric Surgery
Hoim Lee, Hyoju Jeong, Suhye Kwon
Journal of Korean Academy of Nursing.2023; 53(2): 260. CrossRef
Factors Associated With Loss to Follow-up After Laparoscopic Sleeve Gastrectomy: A Single-Center Retrospective Study
Seong-A Jeong, Chang Seok Ko, Na Young Kim, Chung Sik Gong, In-Seob Lee, Beom Su Kim, Moon-Won Yoo
Journal of Metabolic and Bariatric Surgery.2023; 12(1): 1. CrossRef
Restoration for the foregut surgery: bridging gaps between foregut surgery practice and academia
Ye-lim Shin, Shin-Hoo Park, Yeongkeun Kwon, Chang Min Lee, Sungsoo Park
Journal of Minimally Invasive Surgery.2021; 24(4): 175. CrossRef
Early Clinical Outcomes of the Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy by Gastric Cancer Surgeons: the Analysis of Fifty Consecutive Cases
Chang Seok Ko, Jin Ho Jheong, Seong-A Jeong, Chung Sik Gong, In-Seob Lee, Beom Su Kim, Byung Sik Kim, Hye Soon Park, Se Hee Min, Moon-Won Yoo
Journal of Metabolic and Bariatric Surgery.2021; 10(2): 66. CrossRef
The Effect of Pre-operative Information through Audiovisual Media on Self-Care Knowledge, Self-Efficacy, and State Anxiety of Patients before Bariatric Surgery
Ho Im Lee, Jung Suk Park
Korean Journal of Adult Nursing.2020; 32(4): 421. CrossRef
Comparative Efficacy of Bariatric Surgery in the Treatment of Morbid Obesity and Diabetes Mellitus: a Systematic Review and Network Meta-Analysis
Chan Hyuk Park, Seung-Joo Nam, Hyuk Soon Choi, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Jai Hoon Yoon, Sung Hoon Jung, Yil Sik Hyun, Hang Lak Lee
Obesity Surgery.2019; 29(7): 2180. CrossRef
Continuous Positive Airway Pressure Therapy Can Prevent Pulmonary Atelectasis after Laparoscopic Roux-en-Y Gastric Bypass Surgery in Obese Patients
Jong-hyuk Ahn, Eun-Kee Bae, Young-Ju Suh, Yong Sun Jeon, Yeon Ji Lee, Yoonseok Heo
Journal of Metabolic and Bariatric Surgery.2019; 8(1): 8. CrossRef
Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef
Surgical Treatment of Morbid Obesity
Chang Min Lee, Jong-Han Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2017; 17(2): 72. CrossRef

Adrenal gland
In Vivo Models for Incretin Research: From the Intestine to the Whole Body: Tae Jung Oh; Endocrinol Metab. 2016;31(1):45-51. Published online March 16, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.1.45

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Incretin hormones are produced by enteroendocrine cells (EECs) in the intestine in response to ingested nutrient stimuli. The incretin effect is defined as the difference in the insulin secretory response between the oral glucose tolerance test and an isoglycemic intravenous glucose infusion study. The pathophysiology of the decreased incretin effect has been studied as decreased incretin sensitivity and/or β-cell dysfunction per se. Interestingly, robust increases in endogenous incretin secretion have been observed in many types of metabolic/bariatric surgery. Therefore, metabolic/bariatric surgery has been extensively studied for incretin physiology, not only the hormones themselves but also alterations in EECs distribution and genetic expression levels of gut hormones. These efforts have given us an enormous understanding of incretin biology from synthesis to in vivo behavior. Further innovative studies are needed to determine the mechanisms and targets of incretin hormones.

Citations

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High-intensity infrasound effects on glucose metabolism in rats
Gonçalo Martins Pereira, Madalena Santos, Sofia S. Pereira, Gonçalo Borrecho, Francisco Tortosa, José Brito, Diamantino Freitas, António Oliveira de Carvalho, Artur Águas, Maria João Oliveira, Pedro Oliveira
Scientific Reports.2021;[Epub] CrossRef
Parboiled rice metabolism differs in healthy and diabetic individuals with similar improvement in glycemic response
Samar Hamad, Tasleem A. Zafar, Jiwan Sidhu
Nutrition.2018; 47: 43. CrossRef
Articles inEndocrinology and Metabolismin 2016
Won-Young Lee
Endocrinology and Metabolism.2017; 32(1): 62. CrossRef
Fibroblast growth factor 21 is required for beneficial effects of exercise during chronic high-fat feeding
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Journal of Applied Physiology.2016; 121(3): 687. CrossRef

Original Articles

Pituitary Apoplexy in Korea - Characteristics, Treatment Options and Outcomes.: Jung Ah Lim, Jin Taek Kim, Min Joo Kim, Tae Hyuk Kim, Yenna Lee, Hwa Young Cho, Chan Soo Shin, Kyong Soo Park, Hak Chul Jang, Bo Youn Cho, Hong Kyu Lee, Seong Yeon Kim; J Korean Endocr Soc. 2009;24(4):247-253. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.247

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BACKGROUND
Reports on pituitary apoplexy in Korea are limited. There are two treatment options for pituitary apoplexy - surgical decompression and conservative management. In this study, we examined clinical presentation and outcomes following different therapies in Korean patients with pituitary apoplexy. METHODS: Clinical data and treatment outcomes from 52 patients with pituitary apoplexy who visited Seoul National University Hospital between January 1992 and June 2008 were reviewed retrospectively. Patients were divided into 2 groups according to management options (a surgery group vs. a conservative management group) and their outcomes were compared. For patients who underwent surgery due to neurological symptoms, outcomes were compared between early and late surgery groups. RESULTS: Headache (73.1%) was the most common presenting symptom, and more than half of the patients were reported to have visual symptoms. The most common type of pathology was a nonfunctioning pituitary adenoma (67.3%). Nine patients received conservative management and 43 underwent surgical decompression. Their recovery from neurological and endocrinological abnormalities were similar. Among patients who showed neurological symptoms, 9 underwent surgery within 1 week of symptom onset and 24 underwent surgery after 1 week. There was no significant difference between outcomes of early and late surgery groups except recovery from impaired visual deficit was greater in the late surgery group. CONCLUSION: Patients with pituitary apoplexy in Korea show similar clinical features as similar patients in other countries. In our study, there was no significant difference between clinical outcomes of the surgery group and the conservative treatment group.

Citations

Citations to this article as recorded by

The Outcomes of Pituitary Apoplexy with Conservative Treatment: Experiences at a Single Institution
Youngbeom Seo, Yong Hwy Kim, Yun-Sik Dho, Jung Hee Kim, Jin Wook Kim, Chul-Kee Park, Dong Gyu Kim
World Neurosurgery.2018; 115: e703. CrossRef
Characteristics and Treatment Options of Pituitary Apoplexy
Dong-Sun Kim
Journal of Korean Endocrine Society.2009; 24(4): 237. CrossRef

Pituitary Hormonal Changes after Transsphenoidal Tumor Removal in Non-Functioning Pituitary Adenoma.: Min Suk Lee, Seung Jin Han, Eun Kyung Kim, Joo An Hwang, Yoon Sok Chung, Se Hyuk Kim, Kyung Gi Cho, Nae Jung Rim, Ho Sung Kim; J Korean Endocr Soc. 2009;24(3):181-188. Published online September 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.3.181

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BACKGROUND
The present study investigated the rates and the potential predictors of either new pituitary loss or recovery of hormonal function after transsphenoidal removal of a non-functioning pituitary adenoma. METHODS: Patients who underwent transsphenoidal removal of a non-functioning pituitary adenoma from January 2003 to December 2007 at Ajou University Medical Center were included in this retrospective analysis. Patients were excluded if they had a history of previous pituitary tumor surgery, or did not have preoperative pituitary hormonal data. RESULTS: Of 42 patients included in the analysis, 36 patients had hypopituitarism, 21 patients had "stalk compression" hyperprolactinemia, and 2 patients had normal pituitary function. At long term follow-up (longer than 6 months), 13 patients showed postoperative pituitary hormonal recovery in at least 1 hormonal axis, while 6 patients had developed postoperative hormonal loss in at least 1 hormonal axis. On analysis, neither preoperative serum prolactin level nor tumor size was related to postoperative pituitary hormonal changes. CONCLUSION: More than 1/3 of patients who underwent transsphenoidal surgery showed postoperative pituitary hormonal recovery.

Citations

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Childhood Onset Pituitary Adenoma: Clinical Presentations and Outcomes of 24 Cases
Hwa Young Kim, Hae Woon Jung, Jieun Lee, Ju Young Yoon, Young Ah Lee, Choong Ho Shin, Sei Won Yang
Annals of Pediatric Endocrinology & Metabolism.2012; 17(2): 82. CrossRef

Analysis of Clinical Features of Korean Patients with Adrenocortical Carcinoma.: Chan Ho Yoon, Tae Sik Jung, Hye Seung Jung, Eun Yonug Lee, Sung Jin Bae, Ji Youn Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 2006;21(1):47-52. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.47

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Abstract PDF

BACKGROUND
Adrenocortical carcinoma (ACC) is an extremely rare tumor. Its early detection is difficult and its prognosis is poor. METHOD: We retrospectively analyzed the medical records of 13 patients with ACC between 1995 and 2005 at Samsung Medical Center. Their clinical features and prognosis were evaluated. RESULTS: The average age of the patients with ACC was 40 years (2~75 years). Eight patients were men and five were women. On the first visit, eight of 13 patients (62%) complained abdominal pain, and abdominal mass was palpable in five of 13 patients (38%). Urinary concentration of 17-ketosteroid collected for 24 hours was increased in two of eight patients (25%). Three out of 13 patients were identified as having functioning adrenal tumors (1 Cushing's syndrome and 2 androgen-producing tumors), and the other 10 patients had hormonally inactive adrenal tumors. Ten patients had tumors in left adrenal gland, and three had in right adrenal gland. At the time of diagnosis, four patients were classified as having stage II, seven as stage III, and two as stage IV. Twelve patients underwent adrenalectomy. One of them received additional chemotherapy, and two patients were treated with external radiation therapy after surgery. The other one patient was treated only with chemotherapy due to the presence of liver metastasis. It was possible to continue the regular follow-up in eight of 13 patients. The median duration of follow-up was 39 months (7~114 months). Six of them are still alive (three have no evidence of disease, one had persistence of disease, and two had recurrence of disease during follow-up period). Two patients died of multiple metastases and lung metastasis, respectively. CONCLUSION: Radical surgery is the only curative approach and is recommended for all patients with resectable tumors, even though in those patients with recurrent disease. There is no consensus concerning adjuvant therapy.

Citations

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A Case Report of Bilateral Adrenocortical Carcinoma Complicated by Adrenal Insufficiency
Min Joo Kim, Jung Hee Kim, Tae Young Kim, Sang Wan Kim
Endocrinology and Metabolism.2011; 26(3): 243. CrossRef

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