Endocrinology and Metabolism

Original Article

Clinical Study
Association of the Preoperative Neutrophil-to-ymphocyte Count Ratio and Platelet-to-Lymphocyte Count Ratio with Clinicopathological Characteristics in Patients with Papillary Thyroid Cancer: Sang Mi Kim, Eun Heui Kim, Bo Hyun Kim, Jong Ho Kim, Su Bin Park, Yoon Jeong Nam, Kang Hee Ahn, Min Young Oh, Won Jin Kim, Yun Kyung Jeon, Sang Soo Kim, Yong Ki Kim, In Ju Kim; Endocrinol Metab. 2015;30(4):494-501. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.494

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Background

Several inflammatory biomarkers, especially a high preoperative neutrophil-to-lymphocyte count ratio (NLR) and platelet-to-lymphocyte count ratio (PLR), are known to be indicator of poor prognosis in several cancers. However, very few studies have evaluated the significance of the NLR and PLR in papillary thyroid cancer (PTC). We evaluated the association of the preoperative NLR and PLR with clinicopathological characteristics in patients with PTC.

Methods

This study included 1,066 female patients who underwent total thyroidectomy for PTC. Patients were stratified into 4 quartiles by preoperative NLR and PLR. And the combination of preoperative NLR and PLR was calculated on the basis of data obtained value of tertile as follows: patients with both an elevated PLR and an elevated NLR were allocated a score of 2, and patients showing one or neither were allocated a score of 1 or 0, respectively.

Results

The preoperative NLR and PLR were significantly lower in patients aged ≥45 years and in patients with Hashimoto's thyroiditis. The PLR was significantly higher in patients with tumor size >1 cm (P=0.021).When the patients were categorized into the aforementioned four groups, the group with the higher preoperative PLR was found to have a significantly increased incidence of lateral lymph node metastasis (LNM) (P=0.018). However, there are no significant association between the combination of preoperative NLR and PLR and prognostic factors in PTC patients.

Conclusion

These results suggest that a preoperative high PLR were significant associated with lateral LNM in female patients with PTC.

Citations

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Association of the Preoperative Inflammation-Based Scores with TNM Stage and Recurrence in Patients with Papillary Thyroid Carcinoma: A Retrospective, Multicenter Analysis

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Hipertiroidi Hastalarında Tedavi Öncesi ve Sonrası Trombosit/Lenfosit ve Nötrofil/Lenfosit Oranlarının Değerlendirilmesi
Çiğdem CİNDOĞLU, Mehmet GÜLER, Mehmet Ali EREN, Tevfik SABUNCU
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Case Report

Adrenal gland
Incidentally Detected Inoperable Malignant Pheochromocytoma with Hepatic Metastasis Treated by Transcatheter Arterial Chemoembolization: Joong Keun Kim, Bo Hyun Kim, Sung Min Baek, Dong Hun Shin, Won Jin Kim, Yun Kyoung Jeon, Sang Soo Kim, In Joo Kim; Endocrinol Metab. 2014;29(4):584-589. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.584

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Abstract PDF PubReader

Malignant pheochromocytoma (PCC) is a rare condition. Although the liver is the second most frequent site of metastasis in malignant PCC, no definite treatments have been established. Herein, we report a case of liver metastasis of PCC that was successfully treated by transcatheter arterial chemoembolization (TACE). A 69-year-old man was admitted to the Department of Gastroenterology for evaluation of an incidental hepatic mass in August 2013. He had undergone right adrenalectomy in May 2005 and PCC had been confirmed on the basis of histopathological findings. Liver biopsy was performed, and metastatic PCC was diagnosed. The lesion appeared inoperable because of invasion of the portal vein and metastases in the lymph nodes along the hepatoduodenal ligament. Thus, TACE was performed instead. After TACE, symptoms including dizziness and cold sweating improved, and the patient's serum catecholamine levels decreased. On the basis of this case, we believe that TACE may be a useful treatment for liver metastasis in malignant PCC.

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Original Articles

Bone Metabolism
Short-Term Caloric Restriction Does Not Reduce Bone Mineral Density in Rats with Early Type 2 Diabetes: Yun Kyung Jeon, Won Jin Kim, Myung Jun Shin, Hae-Young Chung, Sang Soo Kim, Bo Hyun Kim, Seong-Jang Kim, Yong Ki Kim, In Joo Kim; Endocrinol Metab. 2014;29(1):70-76. Published online March 14, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.1.70

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Background

The effect of caloric restriction (CR) in the setting of diabetes on bone metabolism has not yet been fully studied. The aim of this study is to determine if short-term CR alters bone mass and metabolism in Otsuka Long-Evans Tokushima fatty (OLETF) rats, an animal model of type 2 diabetes.

Methods

Four groups (n=5) were created: OLETF rats with food ad libitum (AL), OLETF rats with CR, Long-Evans Tokusima Otsuka (LETO) rats with food AL, and LETO rats with CR. The CR condition was imposed on 24-week-old male rats using a 40% calorie reduction for 4 weeks. The effect of CR on femoral bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry. Serum markers were measured by immunoassay.

Results

After 4 weeks of CR, body weight decreased in both strains. The BMD decreased in LETO rats and was maintained in OLETF rats. After adjustment for body weight, BMD remained lower in LETO rats (P=0.017) but not OLETF rats (P=0.410). Bone-specific alkaline phosphatase levels decreased in LETO rats (P=0.025) but not in OLEFT rats (P=0.347). Serum leptin levels were reduced after CR in both strains, but hyperleptinemia remained in OLETF rats (P=0.009). CR increased 25-hydroxyvitamin D levels in OLETF rats (P=0.009) but not in LETO rats (P=0.117). Additionally, interleukin-6 and tumor necrosis factor-α levels decreased only in OLETF rats (P=0.009).

Conclusion

Short-term CR and related weight loss were associated with decreases of femoral BMD in LETO rats while BMD was maintained in OLETF rats. Short-term CR may not alter bone mass and metabolism in type 2 diabetic rats.

Citations

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Obesity and Metabolism
Adiposity in the Relationship between Serum Vitamin D Level and Insulin Resistance in Middle-Aged and Elderly Korean Adults: The Korea National Health and Nutrition Examination Survey 2008: Ji Hyun Kang, Sang Soo Kim, Seung Su Moon, Won Jin Kim, Min Jung Bae, Bo Gwang Choi, Yun Kyung Jeon, Bo Hyun Kim, Yong Ki Kim, In Joo Kim; Endocrinol Metab. 2013;28(2):96-102. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.96

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Background

The role of adiposity in the relationship between serum vitamin D levels and insulin resistance has not yet been fully studied. This aim of this study is to clarify the role of adiposity in the relationship between serum vitamin D level and insulin resistance among middle-aged and elderly Korean adults.

Methods

We used data from 2,710 individuals aged ≥50 years based on national data from a representative sample of the fourth Korea National Health and Nutrition Examination Survey IV-2 in 2008.

Results

After adjustment for potential confounders, body mass index (BMI) was significantly associated with 25(OH) vitamin D (P=0.008). However, waist circumference was not significantly associated with 25(OH) vitamin D. In the stratified analyses, 25(OH) vitamin D was found to be negatively associated with fasting insulin and homeostasis model assessment estimate of insulin resistance (HOMA-IR) in participants with BMIs ≥25 kg/m² (P=0.003 for both insulin and HOMR-IR) but was not found to be associated in those with BMIs <23 kg/m². However, we observed a significant inverse in the association of 25(OH) vitamin D with fasting insulin and HOMA-IR in both the normal (P=0.001 and P<0.001 and the abdominally obese group (P=0.010 and P=0.009) in the stratified analyses according to abdominal obesity.

Conclusion

Our results support that the idea that endogenously-produced vitamin D might be stored in subcutaneous fat deposits. In addition, the association of vitamin D with insulin resistance in middle-aged and elderly Korean adults was stronger when it was stratified by BMI than when abdominal obesity status.

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Case Report

Thyroid Dysfunction Induced by Metastatic Thyroid Cancer: Report of Two Cases.: Kang Hee Ahn, Bo Kyung Choi, Won Jin Kim, Bo Gwang Choi, Yun Kyung Jeon, Sang Soo Kim, Soo Hyung Lee, Bo Hyun Kim, Yong Ki Kim, In Ju Kim; Endocrinol Metab. 2010;25(4):370-373. Published online December 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.4.370

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Abstract PDF: Metastases to the thyroid gland are not frequently observed in clinical practice, although an overall incidence of secondary thyroid malignant tumors has been reported to range from 1.25% to 24% in autopsy series. Generally, patients with metastatic thyroid cancer present with euthyroidism and they do not develop thyroid dysfunction. Thyroid dysfunctions, including hypothyroidism and hyperthyroidism, rarely occur in patients with metastatic thyroid cancer. We describe here a case of hypothyroidism induced by thyroid metastasis from cancer of an unknown primary site in a 53-year-old man and another case of thyrotoxicosis induced by thyroid metastasis from lung cancer in a 65-year-old man.

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