Endocrinology and Metabolism

Original Articles

Diabetes, Obesity and Metabolism Big Data Articles (National Health Insurance Service Database)
Metformin and Cervical Cancer Risk in Patients with Newly Diagnosed Type 2 Diabetes: A Population-Based Study in Korea: Hyun Min Kim, Min Jin Kang, Sun Ok Song; Endocrinol Metab. 2022;37(6):929-937. Published online December 26, 2022; DOI: https://doi.org/10.3803/EnM.2022.1613; Correction in: Endocrinol Metab 2023;38(1):174

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Background
Cervical cancer is a prevalent malignancy that is a major health problem for women worldwide. The cancer-preventive properties of metformin are well-known, but insufficient data have been reported regarding its relationship to cervical cancer. Therefore, in a nationwide population-based study, we investigated the association between metformin use and cervical cancer incidence in patients with newly diagnosed type 2 diabetes.
Methods
This retrospective cohort study used the Korean National Health Insurance claims database. Individuals newly diagnosed with type 2 diabetes between January 2005 and December 2009 were included. The occurrence of cervical cancer was explored by matching for age, economic status, region of residence, and use of anti-diabetic medication.
Results
In total, 66,013 metformin users and 64,756 non-users were analyzed. Cervical cancer occurred in 219 metformin users (0.33%) and 274 metformin non-users (0.42%) (hazard ratio [HR], 0.783; 95% confidence interval [CI], 0.655 to 0.036; P=0.007). Moreover, cervical cancer risk was considerably reduced in those treated with a high dose (>1,200,000 mg) or for an extended period (≥2,000 days) compared to non-users (HR, 0.151; 95% CI, 0.093 to 0.243; P<0.001; and HR, 0.141; 95% CI, 0.077 to 0.258; P<0.001). The incidence was also significantly lower in metformin users among those over 50 years old (HR, 0.791; 95% CI, 0.650 to 0.961; P<0.001).
Conclusion
Metformin use in patients with newly diagnosed diabetes was associated with a lower risk of cervical cancer in Korea. Furthermore, a significant association was found between the use of metformin and cervical cancer in a dose- and duration-dependent manner and among those over 50 years old.

Citations

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Repurposing of Chronically Used Drugs in Cancer Therapy: A Chance to Grasp
Mohamad Ali Hijazi, André Gessner, Nahed El-Najjar
Cancers.2023; 15(12): 3199. CrossRef
Network-based drug repurposing for HPV-associated cervical cancer
Faheem Ahmed, Young Jin Yang, Anupama Samantasinghar, Young Woo Kim, Jeong Beom Ko, Kyung Hyun Choi
Computational and Structural Biotechnology Journal.2023; 21: 5186. CrossRef
The Use of Metformin and Postoperative Insulin Pump Were Predictive Factors for Outcomes of Diabetic Colorectal Cancer Patients after Surgery
Xu-Rui Liu, Fei Liu, Zi-Wei Li, Quan Lv, Xin-Peng Shu, Lian-Shuo Li, Yue Tong, Wei Zhang, Dong Peng
Nutrition and Cancer.2023; 75(10): 1926. CrossRef

Diabetes, Obesity and Metabolism Big Data Articles (National Health Insurance Service Database)
Risk of Diabetes in Subjects with Positive Fecal Immunochemical Test: A Nationwide Population-Based Study: Kwang Woo Kim, Hyun Jung Lee, Kyungdo Han, Jung Min Moon, Seung Wook Hong, Eun Ae Kang, Jooyoung Lee, Hosim Soh, Seong-Joon Koh, Jong Pil Im, Joo Sung Kim; Endocrinol Metab. 2021;36(5):1069-1077. Published online October 28, 2021; DOI: https://doi.org/10.3803/EnM.2021.1119

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Abstract PDF PubReader ePub

Background
Positive fecal immunochemical test (FIT) results have been recently suggested as a risk factor for systemic inflammation. Diabetes induces inflammation in the gastrointestinal tract via several ways. We investigated the association between FIT results and the incidence of diabetes.
Methods
A total of 7,946,393 individuals aged ≥50 years from the National Cancer Screening Program database who underwent FIT for colorectal cancer (CRC) screening from 2009 to 2012 were enrolled. The primary outcome was newly diagnosed diabetes based on the International Classification of Disease 10th revision codes and administration of anti-diabetic medication during the follow-up period.
Results
During a mean follow-up of 6.5 years, the incidence rates of diabetes were 11.97, 13.60, 14.53, and 16.82 per 1,000 personyears in the FIT negative, one-positive, two-positive, and three-positive groups, respectively. The hazard ratios (HRs) for the incidence of diabetes were 1.14 (95% confidence interval [CI], 1.12 to 1.16; HR, 1.21; 95% CI, 1.16 to 1.27; and HR, 1.40; 95% CI, 1.28 to 1.55) in the one-positive, two-positive, and three-positive FIT groups compared with the FIT negative group, respectively. The effect was consistent in individuals with normal fasting blood glucose (adjusted HR 1.55 vs. 1.14, P for interaction <0.001).
Conclusion
Positive FIT results were associated with a significantly higher risk of diabetes, suggesting that the FIT can play a role not only as a CRC screening tool, but also as a surrogate marker of systemic inflammation; thus, increasing the diabetes risk.

Citations

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Uncovering a dose-response relationship between positive fecal immunochemical test (FIT) and all-cause, cardiovascular and cancer-related mortality
Chi Pang Wen, Min Kuang Tsai, June Han Lee, Hung Yi Chiou, Christopher Wen, Ta-Wei David Chu, Chien Hua Chen
European Journal of Internal Medicine.2024; 120: 69. CrossRef
Faecal haemoglobin concentrations are associated with all-cause mortality and cause of death in colorectal cancer screening
Lasse Kaalby, Ulrik Deding, Issam Al-Najami, Gabriele Berg-Beckhoff, Thomas Bjørsum-Meyer, Tinne Laurberg, Aasma Shaukat, Robert J. C. Steele, Anastasios Koulaouzidis, Morten Rasmussen, Morten Kobaek-Larsen, Gunnar Baatrup
BMC Medicine.2023;[Epub] CrossRef
Positive Results from the Fecal Immunochemical Test Can Be Related to Dementia: A Nationwide Population-Based Study in South Korea
Yu Kyung Jun, Seung Woo Lee, Kwang Woo Kim, Jung Min Moon, Seong-Joon Koh, Hyun Jung Lee, Joo Sung Kim, Kyungdo Han, Jong Pil Im
Journal of Alzheimer's Disease.2023; 91(4): 1515. CrossRef
Faecal Haemoglobin Estimated by Faecal Immunochemical Tests—An Indicator of Systemic Inflammation with Real Clinical Potential
Karen N. Barnett, Gavin R. C. Clark, Robert J. C. Steele, Callum G. Fraser
Diagnostics.2021; 11(11): 2093. CrossRef

Clinical Characteristics of Patients with Adrenal Insufficiency in a General Hospital: Ye Yeon Lee, Nan Hee Cho, Jong Won Lee, Nam Kyung Kim, Hye Soon Kim, Mi-Kyung Kim; Endocrinol Metab. 2017;32(1):83-89. Published online February 28, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.1.83

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Background

Adrenal insufficiency (AI) is a life-threatening disorder caused by the deficiency of adrenal steroid hormones. This retrospective cross-sectional study investigated the characteristics of patients with AI in Korea.

Methods

All consecutive patients with suspected AI who received care at a tertiary referral center in Korea in 2014 and underwent adrenocorticotropic hormone stimulation or insulin-tolerance testing were identified through a review of medical charts. Patients diagnosed with AI were enrolled. Their demographic, clinical, and treatment details were extracted.

Results

Of 771 patients with suspected AI, 183 (23.7%) received a definitive diagnosis. The most common reason for testing was the presence of suspicious AI-related symptoms (30.0%), followed by a history of steroid medications (23.5%). Their mean age was 66.7 years, and females predominated (67.8%). The most common symptoms were general weakness, anorexia, arthralgia, and fever. Approximately half (53.6%) had a history of steroid use. Hydrocortisone was the most common treatment (71.6%), with most patients taking a 30 mg dose (44.2%). The most common dose frequency was twice a day (78.6%). Fourteen patients were treated for adrenal crisis (n=10, 5.5%) or an intercurrent illness (n=4, 2.2%).

Conclusion

AI may have been caused by steroid medication use in many of the patients included in this study. The detection of AI can be improved by careful history-taking and being alert to the possibility that a patient has used steroids.

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Thyroid
Standardized Thyroid Cancer Mortality in Korea between 1985 and 2010: Yun Mi Choi, Tae Yong Kim, Eun Kyung Jang, Hyemi Kwon, Min Ji Jeon, Won Gu Kim, Young Kee Shong, Won Bae Kim; Endocrinol Metab. 2014;29(4):530-535. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.530

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Background

The prevalence of thyroid cancer has increased very rapidly in Korea. However, there is no published report focusing on thyroid cancer mortality in Korea. In this study, we aimed to evaluate standardized thyroid cancer mortality using data from Statistics Korea (the Statistical Office of Korea).

Methods

Population and mortality data from 1985 to 2010 were obtained from Statistics Korea. Age-standardized rates of thyroid cancer mortality were calculated according to the standard population of Korea, as well as World Health Organization (WHO) standard population and International Cancer Survival Standard (ICSS) population weights.

Results

The crude thyroid cancer mortality rate increased from 0.1 to 0.7 per 100,000 between 1985 and 2010. The pattern was the same for both sexes. The age-standardized mortality rate (ASMR) for thyroid cancer for Korean resident registration population increased from 0.19 to 0.67 between 1985 and 2000. However, it decreased slightly, from 0.67 to 0.55, between 2000 and 2010. When mortality was adjusted using the WHO standard population and ICSS population weights, the ASMR similarly increased until 2000, and then decreased between 2000 and 2010.

Conclusion

Thyroid cancer mortality increased until 2000 in Korea. It started to decrease from 2000.

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Review Article

Bone Metabolism
Vitamin D Status in Korea: Han Seok Choi; Endocrinol Metab. 2013;28(1):12-16. Published online March 25, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.1.12

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The majority of the vitamin D in our body is produced by cutaneous synthesis in response to sunlight. As more and more people live in cities and spend the bulk of their time indoors, it can be difficult to get sufficient sun exposure for adequate cutaneous production of vitamin D. Therefore, vitamin D insufficiency has become a very common health problem worldwide. The Korea National Health and Nutrition Examination Survey IV 2008 showed that the prevalence of vitamin D insufficiency, defined as a serum 25-hydroxyvitamin D [25(OH)D] level below 50 nmol/L, was 47.3% in males and 64.5% in females. Only 13.2% of males and 6.7% of females had a serum 25(OH)D level of greater than 75 nmol/L. In Korea, vitamin D insufficiency was more prevalent in young adults than in elderly people, likely due to the indoor lifestyle of younger people. Compared with the United States and Canada, Korea has a lower mean 25(OH)D level and a higher prevalence of vitamin D insufficiency. To improve the vitamin D status of the Korean population, more aggressive policies on food fortification and vitamin D supplementation are needed.

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Original Article

Prevalence and Characteristics of Metabolically Obese but Normal Weight and Metabolically Healthy but Obese in Middle-aged Koreans: the Chungju Metabolic Disease Cohort (CMC) Study.: Seung Hwan Lee, Hee Sung Ha, Young Jun Park, Jin Hee Lee, Hyeon Woo Yim, Kun Ho Yoon, Moo Il Kang, Won Chul Lee, Ho Young Son, Yong Moon Park, Hyuk Sang Kwon; Endocrinol Metab. 2011;26(2):133-141. Published online June 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.2.133

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Abstract PDF

BACKGROUND
We attempted to determine the prevalence and characteristics of metabolically obese but normal weight (MONW) and metabolically healthy but obese (MHO) individuals in a large cohort of middle-aged Koreans. METHODS: 8,987 non-diabetic subjects were selected from the Chungju Metabolic disease Cohort Study performed in 2003-2006. MONW was defined as a body mass index (BMI) > or = 18.5 and < 23 kg/m2 with a homeostasis model assessment of insulin resistance (HOMA-IR) in the highest quartile. MHO was defined as BMI > or = 25 kg/m2 with HOMA-IR in the lowest quartile. RESULTS: The mean age of the subjects was 62.3 +/- 10.5 years (men 40.4%). The age-adjusted prevalence of MONW and MHO were 4.3% (5.3% men, 3.7% women) and 5.6% (3.6% men, 7.0% women), respectively. 14.2% of men and 12.9% of women were classified as MONW among the normal weight population, whereas 10.7% of men and 14.5% of women were classified as MHO among the obese subjects. The prevalence of prediabetes was significantly higher in the MONW group than in the MHO group (34.7 vs. 12.5%, P < 0.0001 in men; 23.1 vs. 8.8%, P < 0.0001 in women). The MONW group evidenced an equivalent risk of coronary heart disease (CHD) relative to the MHO group (10.77 +/- 0.68 vs. 10.22 +/- 0.90% in men; 7.02 +/- 0.34 vs. 7.26 +/- 0.26% in women, means +/- standard error [SE]). CONCLUSION: The subjects in the MONW group are characterized by a high risk of diabetes and CHD, despite their normal weights. Their substantial prevalence in the population emphasizes the importance of identifying subjects in the MONW group, and warrants more intensive risk management.

Citations

Citations to this article as recorded by

Obesity, metabolic health, and mortality in adults: a nationwide population-based study in Korea
Hae Kyung Yang, Kyungdo Han, Hyuk-Sang Kwon, Yong-Moon Park, Jae-Hyoung Cho, Kun-Ho Yoon, Moo-Il Kang, Bong-Yun Cha, Seung-Hwan Lee
Scientific Reports.2016;[Epub] CrossRef
The Definition of Metabolically Healthy Obesity
Hae Kyung Yang, Seung-Hwan Lee
The Journal of Korean Diabetes.2014; 15(1): 17. CrossRef

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