Endocrinology and Metabolism

Original Articles

Clinical Study
Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity: Suji Yoo, Jaehoon Jung, Hosu Kim, Kyoung Young Kim, Soo Kyoung Kim, Jungwha Jung, Jong Ryeal Hahm, Jong Ha Baek; Endocrinol Metab. 2020;35(4):873-881. Published online December 23, 2020; DOI: https://doi.org/10.3803/EnM.2020.798

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Abstract PDF Supplementary Material PubReader ePub: Background
To examine whether glycated hemoglobin (HbA1c) test would be a suitable screening tool for detecting high-risk subjects for diabetes compared to oral glucose tolerance test (OGTT) according to accompanied central obesity.
Methods
In this prospective population-based cohort study, both OGTT and HbA1c tests were performed and continued every 2 years up to 12 years among individuals with non-diabetic state at baseline (aged 40 to 69 years, n=7,512). Incident diabetes was established by a doctor, HbA1c ≥6.5%, and/or fasting plasma glucose (FPG) ≥126 mg/dL, and/or 2-hour postprandial glucose (2hPG) level based on OGTT ≥200 mg/dL. Discriminative capacities of high HbA1c (≥5.7%) versus high 2hPG (≥140 mg/dL) for predicting incident diabetes were compared using Cox-proportional hazard regression and C-index.
Results
During the median 11.5 years of follow-up period, 1,341 (17.6%) developed diabetes corresponding to an incidence of 22.1 per 1,000 person-years. Isolated high 2hPG was associated with higher risk for incident diabetes (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.56 to 5.17) than isolated high HbA1c (HR, 2.79; 95% CI, 2.40 to 3.26; P<0.05). In addition, high 2hPG provided better discriminatory capacity than high HbA1c (C-index 0.79 vs. 0.75, P<0.05). Meanwhile, in subjects with central obesity, the HR (3.95 [95% CI, 3.01 to 5.18] vs. 2.82 [95% CI, 2.30 to 3.46]) and discriminatory capacity of incident diabetes (C-index 0.75 vs. 0.75) between two subgroups became comparable.
Conclusion
Even though the overall inferior predictive capacity of HbA1c test than OGTT, HbA1c test might plays a complementary role in identifying high risk for diabetes especially in subjects with central obesity with increased sensitivity.

Thyroid
Prognosis of Differentiated Thyroid Carcinoma with Initial Distant Metastasis: A Multicenter Study in Korea: Hosu Kim, Hye In Kim, Sun Wook Kim, Jaehoon Jung, Min Ji Jeon, Won Gu Kim, Tae Yong Kim, Hee Kyung Kim, Ho-Cheol Kang, Ji Min Han, Yoon Young Cho, Tae Hyuk Kim, Jae Hoon Chung; Endocrinol Metab. 2018;33(2):287-295. Published online June 21, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.2.287

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Abstract PDF PubReader ePub

Background

Most patients with differentiated thyroid cancer (DTC) have a favorable prognosis. However, patients with DTC and initial distant metastasis have not been commonly found, and their clinical characteristics have seldom been reported. In this study, we analyzed the clinical features and prognosis of patients with DTC and initial distant metastasis in Korea.

Methods

We retrospectively reviewed the clinical data of 242 patients with DTC and initial distant metastasis treated from 1994 to 2013, collected from five tertiary hospitals in Korea.

Results

The patients' median age was 51 years, and 65% were women. They were followed for a median of 7 years. Lung was the most common site of distant metastasis: only lung 149 patients (62%), only bone 49 (20%), other single site one (pleura), and combined sites 43 (40 were lung and bone, two were bone and other site, and one was lung and other site). At the time of diagnosis, 50 patients (21%) had non-radioactive iodine (RAI) avidity. Five-year disease-specific survival (DSS) was 85% and 10-year DSS was 68%, which were better than those in previous studies. After multivariate analysis, old age, male sex, metastatic site, and histologic type (follicular type) were significant factors for poor prognosis. However, negative RAI avidity status was not a significant prognostic factor after adjusting for other variables.

Conclusion

The prognosis of Korean patients with DTC and initial distant metastasis was better than in previous studies. Old age, male sex, metastasis site, and histologic type were significant prognostic factors.

Citations

Citations to this article as recorded by

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Theranostics of Thyroid Cancer
Luca Giovanella, Murat Tuncel, Atena Aghaee, Alfredo Campenni, Armando De Virgilio, Petra Petranović Ovčariček
Seminars in Nuclear Medicine.2024;[Epub] CrossRef
Thyroid Hormone Withdrawal versus Recombinant Human TSH as Preparation for I-131 Therapy in Patients with Metastatic Thyroid Cancer: A Systematic Review and Meta-Analysis
Luca Giovanella, Maria Luisa Garo, Alfredo Campenní, Petra Petranović Ovčariček, Rainer Görges
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Therapeutic challenges in metastatic follicular thyroid cancer occurring in pregnancy: A case report
Claudio Spinelli, Beatrice Sanna, Marco Ghionzoli, Elisabetta Micelli
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Initial clinical and treatment patterns of advanced differentiated thyroid cancer: ERUDIT study
Juan Antonio Vallejo Casas, Marcel Sambo, Carlos López López, Manuel Durán-Poveda, Julio Rodríguez-Villanueva García, Rita Joana Santos, Marta Llanos, Elena Navarro-González, Javier Aller, Virginia Pubul, Sonsoles Guadalix, Guillermo Crespo, Cintia Gonzál
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Male sex is not an independent risk factor for recurrence of differentiated thyroid cancer: a propensity score-matching study
Joonseon Park, Kwangsoon Kim, Dong-Jun Lim, Ja Seong Bae, Jeong Soo Kim
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Evaluation of the 2015 ATA Guidelines in Patients With Distant Metastatic Differentiated Thyroid Cancer
Evert F S van Velsen, Merel T Stegenga, Folkert J van Kemenade, Boen L R Kam, Tessa M van Ginhoven, W Edward Visser, Robin P Peeters
The Journal of Clinical Endocrinology & Metabolism.2020; 105(3): e457. CrossRef
Usefulness of a 3D‐Printed Thyroid Cancer Phantom for Clinician to Patient Communication
Dayeong Hong, Sangwook Lee, Taehun Kim, Jung Hwan Baek, Won Woong Kim, Ki‐Wook Chung, Namkug Kim, Tae‐Yon Sung
World Journal of Surgery.2020; 44(3): 788. CrossRef
Estimating the Growth Rate of Lung Metastases in Differentiated Thyroid Carcinoma: Response Evaluation Criteria in Solid Tumors or Doubling Time?
Eyun Song, Jonghwa Ahn, Min Ji Jeon, Sang Min Lee, Jeong Hyun Lee, Tae Yong Kim, Jung Hwan Baek, Won Bae Kim, Young Kee Shong, Won Gu Kim
Thyroid.2020; 30(3): 418. CrossRef
Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts
Alfredo Campennì, Daniele Barbaro, Marco Guzzo, Francesca Capoccetti, Luca Giovanella
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Unusual metastases from differentiated thyroid cancers: A multicenter study in Korea
Jee Hee Yoon, Min Ji Jeon, Mijin Kim, A. Ram Hong, Hee Kyung Kim, Dong Yeob Shin, Bo Hyun Kim, Won Bae Kim, Young Kee Shong, Ho-Cheol Kang, Domenico Albano
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Extended Real-World Observation of Patients Treated with Sorafenib for Radioactive Iodine-Refractory Differentiated Thyroid Carcinoma and Impact of Lenvatinib Salvage Treatment: A Korean Multicenter Study
Hye-Seon Oh, Dong Yeob Shin, Mijin Kim, So Young Park, Tae Hyuk Kim, Bo Hyun Kim, Eui Young Kim, Won Bae Kim, Jae Hoon Chung, Young Kee Shong, Dong Jun Lim, Won Gu Kim
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Clinical outcomes and prognostic factors in patients with no less than three distant organ system metastases from differentiated thyroid carcinoma
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Molecular Profile and Clinical Outcomes in Differentiated Thyroid Cancer Patients Presenting with Bone Metastasis
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Improved survival after early detection of asymptomatic distant metastasis in patients with thyroid cancer
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Risk Factors for Distant Metastasis in Follicular Thyroid Carcinoma in Korea
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Clinical Outcomes of Differentiated Thyroid Cancer Patients with Local Recurrence or Distant Metastasis Detected in Old Age
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Efficacy and Affecting Factors of 131I Thyroid Remnant Ablation After Surgical Treatment of Differentiated Thyroid Carcinoma
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Clinical Study
Recovery of Adrenal Function in Patients with Glucocorticoids Induced Secondary Adrenal Insufficiency: Jong Ha Baek, Soo Kyoung Kim, Jung Hwa Jung, Jong Ryeal Hahm, Jaehoon Jung; Endocrinol Metab. 2016;31(1):153-160. Published online March 16, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.1.153

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11 Web of Science
10 Crossref

Abstract PDF PubReader

Background

The chronic use of glucocorticoids (GC) suppresses function of the hypothalamic-pituitary-adrenal axis and often results in secondary adrenal insufficiency (AI). The present study aimed to determine the recovery rate of adrenal function in patients with secondary AI within 1 to 2 years and to assess the factors predictive of adrenal function recovery.

Methods

This was a retrospective observational study that enrolled patients diagnosed with GC-induced secondary AI between 2007 and 2013. AI was defined by peak serum cortisol levels <18 µg/dL during a standard-dose short synacthen test (SST). A follow-up SST was performed after 1 to 2 years, and responders were defined as those with adrenocorticotropic hormone (ACTH)-stimulated peak serum cortisol levels ≥18 µg/dL.

Results

Of the total 34 patients diagnosed with GC-induced secondary AI at first, 20 patients (58.8%) recovered normal adrenal function by the time of the follow-up SST (median follow-up period, 16.5 months). Although the baseline serum ACTH and cortisol levels at the first SST did not differ between responders and non-responders, the incremental cortisol response during the first SST was higher in responders than that of non-responders (7.88 vs. 3.56, P<0.01). Additionally, higher cortisol increments during the first SST were an independent predictive factor of the adrenal function recovery (odds ratio, 1.58; 95% confidence interval, 1.02 to 2.46; P<0.05).

Conclusion

In the present study, adrenal function recovery was achieved frequently in patients with GC-induced secondary AI within 1 to 2 years. Additionally, an incremental cortisol response at the first SST may be an important predictive factor of adrenal function recovery.

Citations

Citations to this article as recorded by

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