Endocrinology and Metabolism

Brief Report

Hypothalamus and Pituitary gland
Reference Ranges of Serum Insulin-Like Growth Factor-I and Insulin-Like Growth Factor Binding Protein-3: Results from a Multicenter Study in Healthy Korean Adults: In-Kyung Jeong, Jong Kyu Byun, Junghyun Noh, Sang Wan Kim, Yoon-Sok Chung, Tae Sun Park, Sung-Woon Kim; Endocrinol Metab. 2020;35(4):954-959. Published online December 1, 2020; DOI: https://doi.org/10.3803/EnM.2020.785

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Insulin-like growth factor-I (IGF-I) plays a pivotal role in the diagnosis and treatment of growth hormone (GH) excess or deficiency. The GH study group of the Korean Endocrine Society aims to establish the Korean reference ranges of serum IGF-I and insulin-like growth factor binding protein-3 (IGFBP-3) and assess the relationship between IGF-I and IGFBP-3 and clinical parameters. Fasting serum was collected from healthy Korean adults at health promotion centers of five hospitals nationwide. Serum IGF-I and IGFBP-3 were measured via an immunoradiometric assay using a DSL kit (Diagnostic Systems Laboratories). Serum samples from 354 subjects (180 male, 174 female) were analyzed based on sex at 10-year intervals from 21 to 70 years. IGF-I levels were inversely correlated with age. After adjustment of age, the IGF-I/IGFBP-3 ratio was significantly negatively associated with blood pressure and free thyroxine and positively associated with weight, hemoglobin, creatinine, alanine transferase, fasting glucose, and thyroid stimulating hormone. Therefore, age- and sex-specific reference ranges of serum IGF-I and IGFBP-3 can be efficient in evaluating GH excess or deficiency in Korean population.

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Capillary blood as a complementary matrix for doping control purposes. Application to the definition of the individual longitudinal profile of IGF-1
Carlotta Stacchini, Francesco Botrè, Xavier de la Torre, Monica Mazzarino
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Review Article

Obesity and Metabolism
Recent Advances in Diagnostic Strategies for Diabetic Peripheral Neuropathy: Jong Chul Won, Tae Sun Park; Endocrinol Metab. 2016;31(2):230-238. Published online May 27, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.2.230

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Diabetes is an increasing epidemic in Korea, and associated diabetic peripheral neuropathy (DPN) is its most common and disabling complication. DPN has an insidious onset and heterogeneous clinical manifestations, making it difficult to detect high-risk patients of DPN. Early diagnosis is recommended and is the key factor for a better prognosis and preventing diabetic foot ulcers, amputation, or disability. However, diagnostic tests for DPN are not clearly established because of the various pathophysiology developing from the nerve injury to clinical manifestations, differences in mechanisms according to the type of diabetes, comorbidities, and the unclear natural history of DPN. Therefore, DPN remains a challenge for physicians to screen, diagnose, follow up, and evaluate for treatment response. In this review, diagnosing DPN using various methods to assess clinical symptoms and/or signs, sensorineural impairment, and nerve conduction studies will be discussed. Clinicians should rely on established modalities and utilize current available testing as complementary to specific clinical situations.

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Case Reports

Thyroid
Papillary Thyroid Carcinoma: Four Cases Required Caution during Long-Term Follow-Up: Hea Min Yu, Jae Min Lee, Kang Seo Park, Tae Sun Park, Heung Young Jin; Endocrinol Metab. 2013;28(4):335-340. Published online December 12, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.4.335

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Due to the increased prevalence of papillary thyroid carcinoma (PTC), difficult cases and unexpected events have become more common during long-term follow-up. Herein we reported four cases that exhibited poor progress during long-term follow-up. All the cases were diagnosed with PTC and treated with total thyroidectomy before several years, and the patients had been newly diagnosed with recurrent and metastatic PTC. These four cases included recurred PTC with invasion of large blood vessels, a concomitant second malignancy, malignant transformation, and refractoriness to treatment. Physicians should closely monitor patients to promptly address unforeseen circumstances during PTC follow-up, including PTC recurrence and metastasis. Furthermore, we suggest that the development of a management protocol for refractory or terminal PTC is also warranted.

Citations

Citations to this article as recorded by

Induction of epithelial-mesenchymal transition in thyroid follicular cells is associated with cell adhesion alterations and low-dose hyper-radiosensitivity
Ankit Mathur, Vijayakumar Chinnadurai, Param Jit Singh Bhalla, Sudhir Chandna
Tumor Biology.2023; 45(1): 95. CrossRef
Thyroglobulin Level in Fine-Needle Aspirates for Preoperative Diagnosis of Cervical Lymph Node Metastasis in Patients with Papillary Thyroid Carcinoma: Two Different Cutoff Values According to Serum Thyroglobulin Level
Min Ji Jeon, Won Gu Kim, Eun Kyung Jang, Yun Mi Choi, Yu-Mi Lee, Tae-Yon Sung, Jong Ho Yoon, Ki-Wook Chung, Suck Joon Hong, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Won Bae Kim
Thyroid.2015; 25(4): 410. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef

A Case of Simultaneous Presentation of Thyroid Crisis and Diabetic Ketoacidosis.: Kyung Ae Lee, Kyung Taek Park, Hea Min Yu, Heung Yong Jin, Ji Hyun Park, Hong Sun Baek, Tae Sun Park; Endocrinol Metab. 2012;27(1):63-67. Published online March 1, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.1.63

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Two important endocrine emergencies, thyroid crisis and diabetic ketoacidosis (DKA), are uncommon when presented together, but pose serious complications. Without appropriate management, they may result in high mortality. Although several cases of simultaneous presentation of thyroid crisis and DKA have been reported, it is a clinically unusual situation and remains a diagnostic and management challenge in clinical practice. We report rare case with simultaneous presentation of thyroid crisis and DKA without previous warning symptoms. A 23-year-old-woman was brought to the emergency department presenting with acute abdominal pain for one day. She was healthy and there was no personal history of diabetes or thyroid disease. Through careful physical examination and laboratory tests, the patient was diagnosed with thyroid crisis combined with DKA. Concomitance of these two endocrine emergencies led to sudden cardiac arrest, but she was successfully resuscitated. This emphasizes the importance of early recognition and prompt management when the two diseases are presented concomitantly.

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Health Behaviors and Risk Factors Associated with Chronic Kidney Disease in Korean Patients with Diabetes: The Fourth Korean National Health and Nutritional Examination Survey
Suk Jeong Lee, Chae Weon Chung
Asian Nursing Research.2014; 8(1): 8. CrossRef

A Case of Concurrent Papillary Thyroid Carcinoma in Familial Medullary Thyroid Microcarcinoma with a Germline C634W Mutation.: Ji Hye Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Baek, Myoung Ja Chung, Ki Hwan Hong; Endocrinol Metab. 2010;25(4):354-359. Published online December 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.4.354

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Abstract PDF: The origins of medullary carcinoma (MTC) and papillary carcinoma (PTC) of the thyroid are embryologically different. Tumors showing concurrent medullary and papillary features are rare and they represent less than 1% of all thyroid malignancies. Hereditary MTC is an autosomal dominantly inherited disease which is genetically determined as part of the MEN 2A, MEN 2B, or variants of MEN 2A such as familial MTC. Germline mutations of the RET gene are the underlying cause of the majority of cases of hereditary medullary carcinomas. The pathogenesis of concurrent PTC with familial MTC has rarely been known. Genetic analysis of the RET oncogene has so far provided conflicting results. Here we describe a family whose sibling was affected by both PTC & MTC, and the family carried a germ-line point mutation in the RET extracellular domain that converted cysteine 634 into tryptophan (C634W).

Retraction of Publication

Retraction: Multi-country Study on the Prevalence and Clinical Features of Peripheral Arterial Disease in Type 2 Diabetic Patients Who are at High Risk for Atherosclerosis.: Sang Youl Rhee, Seungjoon Oh, Young Kil Choi, Doo Man Kim, Bong Yun Cha, Hyun Chul Lee, Seung Woo Ha, In Kyu Lee, Tae Sun Park, Min Young Chung, In Joo Kim, Moon Kyu Lee, Sung Soo Koong, Kyung Soo Park, Kyung Wan Min, Young Seol Kim; J Korean Endocr Soc. 2007;22(6):478. Published online December 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.6.478

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Case Report

Primary Pituitary Abscess: An Unusual Case of Diabetes Insipidus.: Ji Hye Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Baek; J Korean Endocr Soc. 2006;21(5):408-413. Published online October 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.5.408

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Abstract PDF: A 58-year-old man was investigated for his complaints of chronic frontal headache. The endocrinologic hormone studies were compatible with diabetes insipidus and suggestive of panhypopituitarism. Sellar MRI showed a cystic sellar lesion with peripheral rim enhancement after contrast injection, and this led to an initial diagnosis of pituitary adenoma with hemorrhagic necrosis. He underwent an operation via the transsphenoidal approach to access the pituitary gland. During the operation, purulent materials were obtained and no tumor or other associated lesions were detected. There was no evidence of current or previous septicemic illness, meningitis, cavernous sinus thrombosis or sinus infection. All the cultures we obtained were negative. He was put on antibiotics and discharged after 4 weeks. Now, 18 months after treatment, he is doing well.

Original Articles

Multi-country Study on the Prevalence and Clinical Features of Peripheral Arterial Disease in Type 2 Diabetic Patients Who are at High Risk for Atherosclerosis.: Sang Youl Rhee, Seungjoon Oh, Young Kil Choi, Doo Man Kim, Bong Yun Cha, Hyun Chul Lee, Seung Woo Ha, In Kyu Lee, Tae Sun Park, Min Young Chung, In Joo Kim, Moon Kyu Lee, Sung Soo Koong, Kyung Soo Park, Kyung Wan Min, Young Seol Kim; J Korean Endocr Soc. 2006;21(4):290-301. Published online August 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.4.290

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Abstract PDF: BACKGROUND
PAD-SEARCH (Peripheral Arterial Disease-Screening and Evaluation of diabetic patients in Asian Regions Characterized by High risk factors) is the first international study to investigate the prevalence of peripheral arterial disease (PAD) in Asian type 2 diabetic patients and to demonstrate the relationships between the putative risk factors and PAD in this population. METHODS: A total of 6,625 type 2 diabetic patients (2,873 males and 3,752 females aged 50 and older) were enrolled in PAD-SEARCH in Korea, China, Taiwan, Hong Kong, Indonesia, Thailand and Philippines from October 2003 to March 2004. The Fukuda vascular profile VS-1000(TM) was used to determine the ankle-brachial index (ABI) and the brachial-ankle pulse wave velocity (baPWV). RESULTS: The mean patient age was 63.7 +/- 8.2 years and the mean duration of diabetes was 10.3 +/- 8.0 years. 1,172 (17.7%) subjects were diagnosed as PAD by the ABI (< or = 0.9). Subjects with PAD had a significantly longer duration of diabetes or hypertension, a higher HbA1c level and a significantly lower mean BMI than did the non-PAD subjects. In terms of the lipid profiles, triglyceride was the only significant variable. Notably, the mean ABI and baPWV in the females were significantly poorer than the age matched males for the in subjects with a normal ABI. However, the mean ABI and baPWV in males were significantly poorer than those of the age matched females for the subjects with PAD. On the multivariate analysis, gender, age, BMI, smoking status, duration of diabetes and a previous history of cerebrovascular disease were identified as the independent risk factors of PAD. CONCLUSION: These findings suggest that PAD is a common complication in Asian type 2 diabetic patients. Therefore, PAD screening and treatment should be emphasized for Asian diabetic patients with high risk factors.

Thyroid Function and Clinical Characteristics in Patients with Severe Hypermesis Gravidarum.: Byoung Sik Moon, Tae Sun Park; J Korean Endocr Soc. 1998;13(1):52-59. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The relation between clinical characteristics and a change of thymid functions in patients with hyperemesis gavidarum(HO) has not been well described. In order to clarify this characteristics, we evaluated thyroid function in patients with HG and compared the relationship to clinical characteristics of gestational thyrotoxicosis and hyperemesis. METHODS: From March, 1991, to April, 1997, 20 patients were admitted to the department of obstetrics in Chonbuk National University Hospital because of HG. We examined clinical characteristics of patients with HG(age, marrital age, levels of educations, obstetrical history, gestational duration, vomiting duration, degree of weight loss, infant's birth weights, duration of pregnancy). Thyroid functions, liver functions and serum electrolytes was measured. Also, we compared to the clinical characteristics of patients with HG according to thyroxine concentration. RESULTS: An increased free thyroxine concentration was observed m 65% of 20 pregnancies complicated by severe HG. The level of serum ALT was greater in thyrotoxicosis patients(91.2+-76.6 IU/L, mean +-SD) than normothyroxemic patients(20.3+-12.7 IU/L, P=0.027). Also, increased level of serum AST was observed in patients with HG. In patients with thyrotoxicosis, the long durations of vomiting was observed. CONCLUSIONS: Increased free thyroxine concentration is found in severe HG. Because the relatively higher risk for thyrotoxicosis, patients with severe hyperemesis, they must be evaluated about thyroid functions.

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