Endocrinology and Metabolism

Original Articles

Adrenal Gland
Lipid Profiles in Primary Aldosteronism Compared with Essential Hypertension: Propensity-Score Matching Study: Sun Joon Moon, Han Na Jang, Jung Hee Kim, Min Kyong Moon; Endocrinol Metab. 2021;36(4):885-894. Published online August 10, 2021; DOI: https://doi.org/10.3803/EnM.2021.1012

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Background
There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function.
Methods
Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively.
Results
Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed.
Conclusion
PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.

Citations

Citations to this article as recorded by

Comparison of saline infusion test and captopril challenge test in the diagnosis of Chinese with primary aldosteronism in different age groups
Kaiwen Sun, Minghui Gong, Yang Yu, Minghui Yang, Ying Zhang, Yinong Jiang, Wei Song
Frontiers in Endocrinology.2024;[Epub] CrossRef
Meta‐analysis of blood parameters related to lipid and glucose metabolism between two subtypes of primary aldosteronism
Qiu‐Gen Zhu, Feng Zhu
The Journal of Clinical Hypertension.2023; 25(1): 13. CrossRef
2023 Korean Endocrine Society Consensus Guidelines for the Diagnosis and Management of Primary Aldosteronism
Jeonghoon Ha, Jung Hwan Park, Kyoung Jin Kim, Jung Hee Kim, Kyong Yeun Jung, Jeongmin Lee, Jong Han Choi, Seung Hun Lee, Namki Hong, Jung Soo Lim, Byung Kwan Park, Jung-Han Kim, Kyeong Cheon Jung, Jooyoung Cho, Mi-kyung Kim, Choon Hee Chung
Endocrinology and Metabolism.2023; 38(6): 597. CrossRef
The differences of serum lipid profiles between primary aldosteronism and essential hypertension: a meta-analysis and systematic review
Worapaka Manosroi, Pitchaporn Phudphong, Pichitchai Atthakomol, Mattabhorn Phimphilai
BMC Endocrine Disorders.2022;[Epub] CrossRef

Efficacy of Fluvastatin in Patients with Hypercholesterolemia.: Moon Ho Kang, Sung Gwang Lee, Jung Ho Youn, Tae Suk Kim, Seung Woon Ahn; J Korean Endocr Soc. 1996;11(1):75-84. Published online November 7, 2019

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Abstract PDF: Background
Fluvastatin is the first entirely synthetic 3-hydroxy-3-methylglutaryl-coenzyme A(HMG-CoA) reductase inhibitor. Clinical data indicate that this agent exhibits the proven efficacy of its class and also has some theoretical advantages in safety for long-term use because of its unique pharmacololgic property consistent with hepatoselectivity(i.e., low systemic exposure). This study is to evaluate efficacy and safety of fluvastatin in hypercholesterolemic patients in Korea. Methods: An open clinical trial with fluvastatin was conducted in 31 subjects who continued to have high blood cholesterol levels of 6.21 mmol/L(240 mg/dl) or greater after 1 month of lipid-lowering diet plus single blind placebo period. Fluvastatin was administered for 8 weeks with the initial dose of 20 mg per day and if serum cholesterol levels did not fall below 5.20 mmol/L(200 mg/dl) after 4 weeks the dose was increased to 40 mg per day for the second 4 weeks. On each visit every 4 weeks they underwent interview and laboratory tests about side effects and tolerability. Results: The mean % changes in plasma total cholesterol and LDL-cholesterol from baseline were -14.6% and -20.2% at 4 week, and -19.5% and -24.7% at 8 week respectively(p<0.001). No significant change in plasma triglyceride was found in the overall group, but when analysis is confined to those with hypertriglycedemia combined(TG>- 2.26 mmol/L or 200 mg/dl), plasma triglyceride levels were significantly reduced by 23.3% at 8 week(p<0.05). There was no significant change in HDL-cholesterol during fluvastatin treatment. Three patients had mild gastrointestinal symptoms and one patient developed drowsiness, no symptoms were severe enough to discontinue the medication. Notable laboratory abnormalities including serum transaminase and creatine kinase elevations were not observed. Conclusion: This study suggests that fluvastatin is an effective, safe, and well-tolerated lipid lowering agent in the treatment of hypercholesterolemia. Controlled clinical studies on large scale and long-term basis should be followed.

Review Article

Prevalence and Clinical Characteristics of Dyslipidemia in Koreans: Jee-Sun Jeong, Hyuk-Sang Kwon; Endocrinol Metab. 2017;32(1):30-35. Published online March 20, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.1.30

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The prevalence of hypercholesterolemia in Koreans 30 years old and over was 19.5% in 2015 according to the Korean Nutrition and Health Examination Survey, which means that one-fifth of adults had hypercholesterolemia. The prevalence of hypertriglyceridemia in adults 30 years of age and older was 16.8% in 2015, and men had a 2-fold higher prevalence of hypertriglyceridemia than women (23.9% vs. 10.4%). The awareness of hypercholesterolemia in Koreans was higher in women than among men (62.4% vs. 51.4%). It increased with age; the level of awareness in participants 30 to 49 years of age (32.1% in men and 32.6% in women) was less than half of that observed among respondents ≥65 years old (77.5% in men and 78.0% in women). Regular check-ups for dyslipidemia and the active management thereof are urgent in Korean men aged 30 to 49. In women, the perimenopausal period is crucial for the prevention and management of metabolic syndrome, including dyslipidemia. Overall, improvements in awareness and treatment in the age group of 30 to 49 years in both men and women remain necessary.

Citations

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Jun Hwa Hong, Ung Jeon, Won-Yong Shin, Weon Kim, Kayeon Seong, Sang-Ho Park, Hee-dong Kim, Joong-Wha Chung, Jaehyuk Choi
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Lipids in Health and Disease.2021;[Epub] CrossRef
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Original Articles

Cholesterol Lowering Effect of Cerivastatin in Korean Patients with Primary Hypercholesterolemia.: Sung Hoon Kim, Dong Jun Kim, Jong Rhulk Hahm, Byung Joon Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 1999;14(4):729-738. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Cerivastatin is a kind of statin, a synthetic HMG-CoA reductase inhibitor with high liver selectivity which lowers plasma cholesterol level by inhibiting endogenous cholesterol synthesis. This study evaluates the efficacy, safety, and tolerability of cerivastatin 0.1 mg and 0.3 mg in Korean patients with primary hypercholesterolemia. METHODS: A parallel group, randomized, placebo-controlled, double-blind study was conducted at Samsung Medical Center. The patients with primary hypercholesterolemia were placed on an American Heart Association Step 1 diet for whole study period. Single-blind placebo was administered for the final 4 weeks of period A, before randomization. Thirty two patients with low-density lipoprotein cholesterol (LDL-C) >160 mg/dL (if patients with a definite personal history of coronary heart disease (CHD) or with two or more cardiovascular risk factors, LDL-C >130 mg/dL) were randomized to 6 weeks treatment with one of the following regimens: cerivastatin 0.1 mg (n=11) or cerivastatin 0.3 mg (n=10) or placebo once daily at bedtime (n=11). RESULTS: Cerivastatin 0.1 mg and 0.3 mg treatment groups produced statistically significant (p<.05) changes at 6 weeks after treatment, compared to baseline and placebo in LDL-C (cerivastatin 0.1 mg 16.3%; cerivastatin 0.3 mg 35.2%; placebo 1.5%) and total cholesterol (cerivastatin 0.1 mg 10.3%; cerivastatin 0.3 mg 26.2%; placebo 1.3%). Cerivastatin 0.1 mg and 0.3 mg treatments were well tolerated and resulted in no significant increase in biochemical or clinical side effects compared to placebo. CONCLUSION: Cerivastatin at doses of 0.1 mg and 0.3 mg/day is a safe, well-tolerated, and highly effective HMG-CoA reductase inhibitor for the treatment of primary hypercholesterolemia.

A Frequency of Hypothyroidism in a Population of Hypercholesterolemin Subjects.: Jae Hoon Chung, Kwang Won Kim, Byoung Joon Kim, Sung Hoon Kim, Kyung Ah Kim, Myung Sik Lee, Moon Gyu Lee, Yong Ki Min, Yun Ho Choi, Myung Hee Shin; J Korean Endocr Soc. 1998;13(3):351-358. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Hypothyroidism is a treatable cause of secondary hyperlipidemia. The lipid profile usually seen is an increased total and low density lipoprotein(LDL) cholesterol, and the plasma triglyceride may also be increased. Hypercholesterolemia associated with hypothyroidism is an important factor in the pathogenesis of coronary artery disease(CAD). And the hyperchole-sterolemia caused by hypothyroidism is potentially reversible by thyroid hormone replacement therapy. Hypothyroidism should be ruled out by routine laboratory screening as a treatable cause of secondary hyperlipidemia and increased CAD risk. We carried out this study aimed at evaluating the frequency of hypothyroidism and its relationship with serum cholesterol concentration in Koreans. METHODS: We investigated 15028(men 8273, women 6755) Korean subjects who visited our hospital center for health promotion during an one year period(from January 1, 1996, to December 31, 1996). Among them, we analyzed 6756 hypercholesterolemic subjects whose serum cholesterol levels were greater than 200 mg/dL. They performed thyroid function tests(total T, T4, and TSH) and lipid profiles(total cholesterol, triglyceride and HDL-cholesterol) were measured by enzyme assay. We defined hypothyroidism by serum thyrotropin values greater than 5 U/mL. RESULTS: The observed prevalence of hypothyroidism was 2.4%(163/6756). Among those with high TSH levels, 17(10.4%) had overt hypothyroidism with a low T4 (below 6 g/dL) level. As we analyzed the frequency of hypothyroidism according to cholesterol range by 20 mg/dL, the frequency was significantly increased in the group whose serum cholesterol levels were greater than 300 mg/dL, especially in women over 50 years of age. Analysis of lipid parameters showed that hypertriglyceridemia was frequent and hyperHDLaemia was observed in hypothyroidic populations. CONCLUSION: Screening for hypothyroidism by measurement of thyrotropin values is of particular importance in patients with hypercholesterolemia. And the frequency of hypothyroidism was more significantly increased in whose serum cholesterol levels were greater than 300 mg/dL, especially in the group of women over 50 years of age.

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