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Original Article
Diabetes, obesity and metabolism
Impact of Antidiabetic Drugs on Clinical Outcomes of COVID-19: A Nationwide Population-Based Study
Han Na Jang, Sun Joon Moon, Jin Hyung Jung, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee
Endocrinol Metab. 2024;39(3):479-488.   Published online January 29, 2024
DOI: https://doi.org/10.3803/EnM.2023.1857
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AbstractAbstract PDFPubReader   ePub   
Background
Inconsistent results have been reported regarding the association between the use of antidiabetic drugs and the clinical outcomes of coronavirus disease 2019 (COVID-19). This study aimed to investigate the effect of antidiabetic drugs on COVID-19 outcomes in patients with diabetes using data from the National Health Insurance Service (NHIS) in South Korea.
Methods
We analyzed the NHIS data of patients aged ≥20 years who tested positive for COVID-19 and were taking antidiabetic drugs between December 2019 and June 2020. Multiple logistic regression analysis was performed to analyze the clinical outcomes of COVID-19 based on the use of antidiabetic drugs.
Results
A total of 556 patients taking antidiabetic drugs tested positive for COVID-19, including 271 male (48.7%), most of whom were in their sixties. Of all patients, 433 (77.9%) were hospitalized, 119 (21.4%) received oxygen treatment, 87 (15.6%) were admitted to the intensive care unit, 31 (5.6%) required mechanical ventilation, and 61 (11.0%) died. Metformin was significantly associated with the lower risks of mechanical ventilation (odds ratio [OR], 0.281; 95% confidence interval [CI], 0.109 to 0.720; P=0.008), and death (OR, 0.395; 95% CI, 0.182 to 0.854; P=0.018). Dipeptidylpeptidase-4 inhibitor (DPP-4i) were significantly associated with the lower risks of oxygen treatment (OR, 0.565; 95% CI, 0.356 to 0.895; P=0.015) and death (OR, 0.454; 95% CI, 0.217 to 0.949; P=0.036). Sulfonylurea was significantly associated with the higher risk of mechanical ventilation (OR, 2.579; 95% CI, 1.004 to 6.626; P=0.049).
Conclusion
In patients with diabetes and COVID-19, metformin exhibited reduced risks of mechanical ventilation and death, DPP- 4i was linked with lower risks of oxygen treatment and death, while sulfonylurea was related to the increased risk of mechanical ventilation.
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Letter
Thyroid
Subacute Thyroiditis in the Time of COVID-19
Hwa Young Ahn
Endocrinol Metab. 2024;39(1):186-187.   Published online February 1, 2024
DOI: https://doi.org/10.3803/EnM.2024.1928
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  • 43 Download
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Original Articles
Thyroid
Beyond Acute COVID-19: Investigating the Incidence of Subacute Thyroiditis in Long COVID-19 in Korea
Jeongmin Lee, Gi Hyeon Seo, Keeho Song
Endocrinol Metab. 2023;38(4):455-461.   Published online August 8, 2023
DOI: https://doi.org/10.3803/EnM.2023.1711
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  • 197 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The correlation between acute coronavirus disease 2019 (COVID-19) and subacute thyroiditis (SAT) has not been clearly investigated in “long COVID” patients. We aimed to investigate the incidence of SAT during convalescence and after the acute phase of COVID-19, comparing with that of the general population.
Methods
Data from a total of 422,779 COVID-19 patients and a control group of 2,113,895 individuals were analyzed. The index date was defined as the date 3 months after confirmation of COVID-19. The incidence rate (IR) of SAT and hazard ratios (HRs) were calculated per 100,000 persons. Subgroup analysis included analysis of HRs 90–179 and 180 days post-COVID-19 diagnosis; and additional analysis was conducted according to hospitalization status, sex, and age group.
Results
The IR of SAT was 17.28 per 100,000 persons (95% confidence interval [CI], 12.56 to 23.20) in the COVID-19 group and 8.63 (95% CI, 6.37 to 11.45) in the control group. The HR of COVID-19 patients was 1.76 (95% CI, 1.01 to 3.06; P=0.045). The HR of SAT was 1.39 (95% CI, 0.82 to 2.34; P=0.220) up to 6 months after the index date and 2.30 (95% CI, 1.60 to 3.30; P<0.001) beyond 6 months. The HR for SAT among COVID-19 patients was 2.00 (95% CI, 1.41 to 2.83) in hospitalized patients and 1.76 (95% CI, 1.01 to 3.06) in non-hospitalized patients compared to the control group. The IR of SAT was 27.09 (95% CI, 20.04 to 35.82) for females and 6.47 (95% CI, 3.34 to 11.30) for males. In the 19 to 64 age group, the IR of SAT was 18.19 (95% CI, 13.70 to 23.67), while the IR was 9.18 (95% CI, 7.72 to 10.84) in the 65 to 69 age group.
Conclusion
SAT could be a potential long-term complication of COVID-19. Long-term surveillance for thyroid dysfunction is needed especially in hospitalized, female and young-aged subjects.

Citations

Citations to this article as recorded by  
  • Thyroid dysfunction in COVID-19
    David Tak Wai Lui, Chi Ho Lee, Yu Cho Woo, Ivan Fan Ngai Hung, Karen Siu Ling Lam
    Nature Reviews Endocrinology.2024; 20(6): 336.     CrossRef
  • Subacute Thyroiditis in the Time of COVID-19
    Hwa Young Ahn
    Endocrinology and Metabolism.2024; 39(1): 186.     CrossRef
  • Occult endocrine disorders newly diagnosed in patients with post-COVID-19 symptoms
    Yasuhiro Nakano, Naruhiko Sunada, Kazuki Tokumasu, Hiroyuki Honda, Yuki Otsuka, Yasue Sakurada, Yui Matsuda, Toru Hasegawa, Daisuke Omura, Kanako Ochi, Miho Yasuda, Hideharu Hagiya, Keigo Ueda, Fumio Otsuka
    Scientific Reports.2024;[Epub]     CrossRef
  • Risk of Incident Thyroid Dysfunction in the Post-Acute Phase of COVID-19: A Population-Based Cohort Study in Hong Kong
    David Tak Wai Lui, Xi Xiong, Ching-Lung Cheung, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Celine Sze Ling Chui, Esther Wai Yin Chan, Franco Wing Tak Cheng, Lanlan Li, Matthew Shing Hin Chung, Chi Ho Lee, Yu Cho Woo, Kathryn Choon Beng Tan, Carlos
    Endocrine Practice.2024; 30(6): 528.     CrossRef
  • Subacute Thyroiditis Following COVID-19: A Case of Diagnostic Challenge in the Absence of Neck Pain
    Kan Sakai, Tadahiro Yonaha, Takashi Shinzato, Takahiro Taira
    Cureus.2024;[Epub]     CrossRef
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Adrenal gland
Big Data Articles (National Health Insurance Service Database)
Mortality and Severity of Coronavirus Disease 2019 in Patients with Long-Term Glucocorticoid Therapy: A Korean Nationwide Cohort Study
Eu Jeong Ku, Keeho Song, Kyoung Min Kim, Gi Hyeon Seo, Soon Jib Yoo
Endocrinol Metab. 2023;38(2):253-259.   Published online March 21, 2023
DOI: https://doi.org/10.3803/EnM.2022.1607
  • 3,074 View
  • 107 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The severity of coronavirus disease 2019 (COVID-19) among patients with long-term glucocorticoid treatment (LTGT) has not been established. We aimed to evaluate the association between LTGT and COVID-19 prognosis.
Methods
A Korean nationwide cohort database of COVID-19 patients between January 2019 and September 2021 was used. LTGT was defined as exposure to at least 150 mg of prednisolone (≥5 mg/day and ≥30 days) or equivalent glucocorticoids 180 days before COVID-19 infection. The outcome measurements were mortality, hospitalization, intensive care unit (ICU) admission, length of stay, and mechanical ventilation.
Results
Among confirmed patients with COVID-19, the LTGT group (n=12,794) was older and had a higher proportion of comorbidities than the control (n=359,013). The LTGT group showed higher in-hospital, 30-day, and 90-day mortality rates than the control (14.0% vs. 2.3%, 5.9% vs. 1.1%, and 9.9% vs. 1.8%, respectively; all P<0.001). Except for the hospitalization rate, the length of stay, ICU admission, and mechanical ventilation proportions were significantly higher in the LTGT group than in the control (all P<0.001). Overall mortality was higher in the LTGT group than in the control group, and the significance remained in the fully adjusted model (odds ratio [OR], 5.75; 95% confidence interval [CI], 5.31 to 6.23) (adjusted OR, 1.82; 95% CI, 1.67 to 2.00). The LTGT group showed a higher mortality rate than the control within the same comorbidity score category.
Conclusion
Long-term exposure to glucocorticoids increased the mortality and severity of COVID-19. Prevention and early proactive measures are inevitable in the high-risk LTGT group with many comorbidities.

Citations

Citations to this article as recorded by  
  • Outpatient glucocorticoid use and COVID-19 outcomes: a population-based study
    Almudena Rodríguez-Fernández, Irene Visos-Varela, Maruxa Zapata-Cachafeiro, Samuel Pintos-Rodríguez, Rosa M. García-Álvarez, Teresa M. Herdeiro, María Piñeiro-Lamas, Adolfo Figueiras, Ángel Salgado-Barreira, Rosendo Bugarín-González, Eduardo Carracedo-Mar
    Inflammopharmacology.2024;[Epub]     CrossRef
  • Glucocorticoids as a Double-Edged Sword in the Treatment of COVID-19: Mortality and Severity of COVID-19 in Patients Receiving Long-Term Glucocorticoid Therapy
    Eun-Hee Cho
    Endocrinology and Metabolism.2023; 38(2): 223.     CrossRef
  • Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study
    Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo
    Journal of Clinical Medicine.2023; 12(14): 4799.     CrossRef
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Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
Risk for Newly Diagnosed Type 2 Diabetes Mellitus after COVID-19 among Korean Adults: A Nationwide Matched Cohort Study
Jong Han Choi, Kyoung Min Kim, Keeho Song, Gi Hyeon Seo
Endocrinol Metab. 2023;38(2):245-252.   Published online April 5, 2023
DOI: https://doi.org/10.3803/EnM.2023.1662
  • 2,914 View
  • 131 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Coronavirus disease 2019 (COVID-19) can cause various extrapulmonary sequelae, including diabetes. However, it is unclear whether these effects persist 30 days after diagnosis. Hence, we investigated the incidence of newly diagnosed type 2 diabetes mellitus (T2DM) in the post-acute phase of COVID-19.
Methods
This cohort study used data from the Health Insurance Review and Assessment Service, a representative national healthcare database in Korea. We established a cohort of 348,180 individuals diagnosed with COVID-19 without a history of diabetes between January 2020 and September 2021. The control group consisted of sex- and age-matched individuals with neither a history of diabetes nor COVID-19. We assessed the hazard ratios (HR) of newly diagnosed T2DM patients with COVID-19 compared to controls, adjusted for age, sex, and the presence of hypertension and dyslipidemia.
Results
In the post-acute phase, patients with COVID-19 had an increased risk of newly diagnosed T2DM compared to those without COVID-19 (adjusted HR, 1.30; 95% confidence interval [CI], 1.27 to 1.33). The adjusted HRs of non-hospitalized, hospitalized, and intensive care unit-admitted patients were 1.14 (95% CI, 1.08 to 1.19), 1.34 (95% CI, 1.30 to 1.38), and 1.78 (95% CI, 1.59 to 1.99), respectively. The risk of T2DM in patients who were not administered glucocorticoids also increased (adjusted HR, 1.29; 95% CI, 1.25 to 1.32).
Conclusion
COVID-19 may increase the risk of developing T2DM beyond the acute period. The higher the severity of COVID-19 in the acute phase, the higher the risk of newly diagnosed T2DM. Therefore, T2DM should be included as a component of managing long-term COVID-19.

Citations

Citations to this article as recorded by  
  • New-Onset Diabetes Mellitus in COVID-19: A Scoping Review
    Anca Pantea Stoian, Ioana-Cristina Bica, Teodor Salmen, Wael Al Mahmeed, Khalid Al-Rasadi, Kamila Al-Alawi, Maciej Banach, Yajnavalka Banerjee, Antonio Ceriello, Mustafa Cesur, Francesco Cosentino, Alberto Firenze, Massimo Galia, Su-Yen Goh, Andrej Janez,
    Diabetes Therapy.2024; 15(1): 33.     CrossRef
  • COVID-19 vaccines and blood glucose control: Friend or foe?
    Walter Vena, Stella Pigni, Nazarena Betella, Annalisa Navarra, Marco Mirani, Gherardo Mazziotti, Andrea G. Lania, Antonio C. Bossi
    Human Vaccines & Immunotherapeutics.2024;[Epub]     CrossRef
  • Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study
    Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo
    Journal of Clinical Medicine.2023; 12(14): 4799.     CrossRef
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Editorial
Adrenal gland
Glucocorticoids as a Double-Edged Sword in the Treatment of COVID-19: Mortality and Severity of COVID-19 in Patients Receiving Long-Term Glucocorticoid Therapy
Eun-Hee Cho
Endocrinol Metab. 2023;38(2):223-225.   Published online April 27, 2023
DOI: https://doi.org/10.3803/EnM.2023.201
  • 1,444 View
  • 75 Download
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Review Article
Calcium & Bone Metabolism
Interplay of Vitamin D and CYP3A4 Polymorphisms in Endocrine Disorders and Cancer
Siva Swapna Kasarla, Vannuruswamy Garikapati, Yashwant Kumar, Sujatha Dodoala
Endocrinol Metab. 2022;37(3):392-407.   Published online June 3, 2022
DOI: https://doi.org/10.3803/EnM.2021.1349
  • 6,063 View
  • 207 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract PDFPubReader   ePub   
Vitamin D has received considerable optimistic attention as a potentially important factor in many pathological states over the past few decades. However, the proportion of the active form of vitamin D metabolites responsible for biological activity is highly questionable in disease states due to flexible alterations in the enzymes responsible for their metabolism. For instance, CYP3A4 plays a crucial role in the biotransformation of vitamin D and other drug substances. Food-drug and/or drug-drug interactions, the disease state, genetic polymorphism, age, sex, diet, and environmental factors all influence CYP3A4 activity. Genetic polymorphisms in CYP450-encoding genes have received considerable attention in the past few decades due to their extensive impact on the pharmacokinetic and dynamic properties of drugs and endogenous substances. In this review, we focused on CYP3A4 polymorphisms and their interplay with vitamin D metabolism and summarized the role of vitamin D in calcium homeostasis, bone diseases, diabetes, cancer, other diseases, and drug substances. We also reviewed clinical observations pertaining to CYP3A4 polymorphisms among the aforementioned disease conditions. In addition, we highlighted the future perspectives of studying the pharmacogenetics of CYP3A4, which may have potential clinical significance for developing novel diagnostic genetic markers that will ascertain disease risk and progression.

Citations

Citations to this article as recorded by  
  • Revealing the association between vitamin D metabolic pathway gene variants and lung cancer risk: a systematic review and meta-analysis
    Mohamed I. Elsalahaty, Samar Sami Alkafaas, Aya O. Bashir, Khaled A. El-Tarabily, Mohamed T. El-Saadony, Eman H. Yousef
    Frontiers in Genetics.2024;[Epub]     CrossRef
  • Vitamin D in Melanoma: Potential Role of Cytochrome P450 Enzymes
    Mohamed Ben-Eltriki, Erysa J. Gayle, Jhoanne M. Paras, Louisa Nyame-Addo, Manik Chhabra, Subrata Deb
    Life.2024; 14(4): 510.     CrossRef
  • Explore the mechanism of Astragalus membranaceus and Poria cocos drug pair in improving immunity based on network pharmacology
    Yuting Bai, Na Ning, Jianjun Zhao, Guoqing Chen, Yuhua Du, Shicong Huang, Xilong Jiang, Xuelan Feng, Yuanyuan Feng, Yi Nan, Ling Yuan
    Medicine.2024; 103(25): e38531.     CrossRef
  • Imiglucerase, cholecalciferol, and bone-diet in skeletal health management of type I Gaucher disease patients: a pilot study and systematic review
    Antonio Barbato, Anita Vergatti, Alfonso Giaquinto, Ilaria Libera Pizzulo, Ludovica Perna, Giuseppe Perruolo, Veronica Abate, Michelina Sibilio, Ciro Mainolfi, Ernesto Soscia, Gianpaolo De Filippo, Pietro Formisano, Ferruccio Galletti, Pasquale Strazzullo
    JBMR Plus.2024;[Epub]     CrossRef
  • Heat stress as a potential risk factor for vitamin D deficiency
    Martina Balducci, Letizia Pruccoli, Andrea Tarozzi
    Medical Hypotheses.2023; 176: 111085.     CrossRef
  • Association and Haplotype Analysis of the PON1, ITGB3 and CYP3A4 Genes, Strong Candidates for Familial Coronary Artery Disease Susceptibility
    Faruk SAYDAM, İrfan DEĞİRMENCİ, Alparslan BİRDANE, Cansu ÖZBAYER, Taner ULUS, Mahmut ÖZDEMİR, Necmi ATA, Hasan Veysi GÜNEŞ
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  • Association of flame retardants, polybrominated diethyl ethers (PBDEs), with vitamin D in female subjects
    Alexandra E. Butler, Edwina Brennan, Daniel S. Drage, Thozhukat Sathyapalan, Stephen L. Atkin
    Chemosphere.2023; 338: 139488.     CrossRef
  • Genetic variations of CYP3A4 on the metabolism of itraconazole in vitro
    Sai-li Xie, Xiayan Zhu, Nanyong Gao, Qianmeng Lin, Chaojie Chen, Yun-jun Yang, Jian-ping Cai, Guo-xin Hu, Ren-ai Xu
    Food and Chemical Toxicology.2023; 181: 114101.     CrossRef
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Brief Reports
Diabetes, Obesity and Metabolism
Year-Long Trend in Glycated Hemoglobin Levels in Patients with Type 2 Diabetes during the COVID-19 Pandemic
Jonghwa Jin, Seong Wook Lee, Won-Ki Lee, Jae-Han Jeon, Jung-Guk Kim, In-Kyu Lee, Yeon-Kyung Choi, Keun-Gyu Park
Endocrinol Metab. 2021;36(5):1142-1146.   Published online October 21, 2021
DOI: https://doi.org/10.3803/EnM.2021.1154
  • 4,176 View
  • 152 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
It has been suggested that the coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on glycemic control in patients with type 2 diabetes mellitus (T2DM). However, no study has examined yearly trends in glycated hemoglobin (HbA1c) levels after the start of the COVID-19 outbreak. Here, we performed a retrospective analysis of HbA1c concentrations during the early period of the COVID-19 outbreak (COVID-19 cohort) and then compared the yearly trend in the mean HbA1c level, along with fluctuations in HbA1c levels, with those during previous years (non-COVID-19 cohorts). We observed that the mean HbA1c level in patients with T2DM increased during the first 6 months of the COVID-19 outbreak. After 6 months, HbA1c levels in the COVID-19 cohort returned to levels seen in the non-COVID-19 cohorts. The data suggest that vulnerable patients with T2DM should be monitored closely during the early period of a pandemic to ensure they receive appropriate care.

Citations

Citations to this article as recorded by  
  • Physical and Mental Health Characteristics of Hospitalized COVID-19 Patients with and without Type 2 Diabetes Mellitus in Turkey
    Abdulbari Bener, Murat Atmaca, Abdulla O. A. A. Al-Hamaq, Antonio Ventriglio
    Brain Sciences.2024; 14(4): 377.     CrossRef
  • A Hybrid Model of In-Person and Telemedicine Diabetes Education and Care for Management of Patients with Uncontrolled Type 2 Diabetes Mellitus: Findings and Implications from a Multicenter Prospective Study
    Ayla M. Tourkmani, Turki J. Alharbi, Abdulaziz M. Bin Rsheed, Azzam F. Alotaibi, Mohammed S. Aleissa, Sultan Alotaibi, Amal S. Almutairi, Jancy Thomson, Ahlam S. Alshahrani, Hadil S. Alroyli, Hend M. Almutairi, Mashael A. Aladwani, Eman R. Alsheheri, Hyfa
    Telemedicine Reports.2024; 5(1): 46.     CrossRef
  • Navigating Cardiometabolic Health Behavior during the Pandemic: Strategies for Metabolic Syndrome Management
    Junghyun Noh
    Journal of Obesity & Metabolic Syndrome.2024; 33(2): 89.     CrossRef
  • The indirect impact of the COVID-19 pandemic on people with type 2 diabetes mellitus and without COVID-19 infection: Systematic review and meta-analysis
    Zhuoran Hu, Hin Moi Youn, Jianchao Quan, Lily Luk Siu Lee, Ivy Lynn Mak, Esther Yee Tak Yu, David Vai-Kiong Chao, Welchie Wai Kit Ko, Ian Chi Kei Wong, Gary Kui Kai Lau, Chak Sing Lau, Cindy Lo Kuen Lam, Eric Yuk Fai Wan
    Primary Care Diabetes.2023; 17(3): 229.     CrossRef
  • Evaluating Effects of Virtual Diabetes Group Visits in Community Health Centers During the COVID-19 Pandemic
    Tracy Dinh, Erin M Staab, Daisy Nuñez, Mengqi Zhu, Wen Wan, Cynthia T Schaefer, Amanda Campbell, Michael Quinn, Arshiya A Baig
    Journal of Patient Experience.2023;[Epub]     CrossRef
  • Cardiovascular-related health behavior changes: lessons from the COVID-19 pandemic and post-pandemic challenges
    Inha Jung, Won-Young Lee
    Cardiovascular Prevention and Pharmacotherapy.2023; 5(4): 99.     CrossRef
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Diabetes, Obesity and Metabolism
Dipeptidyl Peptidase-4 Inhibitors and COVID-19-Related Deaths among Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Observational Studies
Dimitrios Patoulias, Michael Doumas
Endocrinol Metab. 2021;36(4):904-908.   Published online July 27, 2021
DOI: https://doi.org/10.3803/EnM.2021.1048
  • 11,613 View
  • 222 Download
  • 18 Web of Science
  • 20 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
The coronavirus disease 2019 (COVID-19) pandemic remains an unbeaten enemy. Unfortunately, no targeted treatment option is available. Patients with type 2 diabetes mellitus (T2DM) have increased odds for severe or fatal disease, as demonstrated in recent observational studies. There is an ongoing discussion regarding the impact of different antidiabetic drug classes on outcomes of interest among affected subjects. Dipeptidyl peptidase-4 (DPP-4) inhibitors have been placed at the epicenter, since the DPP-4 enzyme seems to be implicated in the disease pathogenesis. Herein we present an updated meta-analysis of observational studies addressing the risk of COVID-19 death among patients with T2DM on prior DPP-4 inhibitor treatment. We pooled data from 10 observational studies, showing that DPP-4 inhibitors produce a non-significant decrease in the risk for COVID-19-related death. However, when administered in the inpatient setting, DPP-4 inhibitors decrease the risk for COVID-19-related death by 50%. Ongoing randomized controlled trials will shed further light.

Citations

Citations to this article as recorded by  
  • The Effect of Antihyperglycemic Medications on COVID-19: A Meta-analysis and Systematic Review from Observational Studies
    Zhi-Hui Song, Qiao-Ming Huang, Shan-Shan Xu, Jian-Bo Zhou, Chao Zhang
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    Marija Drakul, Miodrag Čolić
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  • Dipeptidyl peptidase-4 (DPP-IV) inhibitor was associated with mortality reduction in COVID-19 — A systematic review and meta-analysis
    Ahmad Fariz Malvi Zamzam Zein, Wilson Matthew Raffaello
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  • Preadmission use of antidiabetic medications and mortality among patients with COVID-19 having type 2 diabetes: A meta-analysis
    Nam Nhat Nguyen, Dung Si Ho, Hung Song Nguyen, Dang Khanh Ngan Ho, Hung-Yuan Li, Chia-Yuan Lin, Hsiao-Yean Chiu, Yang-Ching Chen
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  • The Association Between Antidiabetic Agents and Clinical Outcomes of COVID-19 Patients With Diabetes: A Bayesian Network Meta-Analysis
    Yidan Chen, Xingfei Lv, Sang Lin, Mohammad Arshad, Mengjun Dai
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Type 2 Diabetes Mellitus and COVID-19: A Narrative Review
    Cristina Rey-Reñones, Sara Martinez-Torres, Francisco M. Martín-Luján, Carles Pericas, Ana Redondo, Carles Vilaplana-Carnerero, Angela Dominguez, María Grau
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  • Role of Dipeptidyl Peptidase-4 (DPP4) on COVID-19 Physiopathology
    Alba Sebastián-Martín, Belén G. Sánchez, José M. Mora-Rodríguez, Alicia Bort, Inés Díaz-Laviada
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    Niya Narayanan, Dukhabandhu Naik, Jayaprakash Sahoo, Sadishkumar Kamalanathan
    World Journal of Virology.2022; 11(6): 399.     CrossRef
  • Improvement of glycemic control and reduction of major cardiovascular events in 18 cardiovascular outcome trials: an updated meta-regression
    Maria Ida Maiorino, Miriam Longo, Lorenzo Scappaticcio, Giuseppe Bellastella, Paolo Chiodini, Katherine Esposito, Dario Giugliano
    Cardiovascular Diabetology.2021;[Epub]     CrossRef
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Original Articles
Diabetes, Obesity and Metabolism
High Fibrosis-4 Index Is Related with Worse Clinical Outcome in Patients with Coronavirus Disease 2019 and Diabetes Mellitus: A Multicenter Observational Study
Sung-Woo Kim, Jae-Han Jeon, Jun Sung Moon, Mi Kyung Kim
Endocrinol Metab. 2021;36(4):800-809.   Published online August 20, 2021
DOI: https://doi.org/10.3803/EnM.2021.1040
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  • 178 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Based on recent evidence on the importance of the presence of diabetes mellitus (DM) and fibrosis-4 (FIB-4) index in coronavirus disease 2019 (COVID-19) mortality, we analyzed whether these factors could additively predict such mortality.
Methods
This multicenter observational study included 1,019 adult inpatients admitted to university hospitals in Daegu. The demographic and laboratory findings, mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM and/or a high FIB-4 index. The mortality risk and corresponding hazard ratio (HR) were analyzed using the Kaplan-Meier method and Cox proportional hazard models.
Results
The patients with DM (n=217) exhibited significantly higher FIB-4 index and mortality compared to those without DM. Although DM (HR, 2.66; 95% confidence interval [CI], 1.63 to 4.33) and a high FIB-4 index (HR, 4.20; 95% CI, 2.21 to 7.99) were separately identified as risk factors for COVID-19 mortality, the patients with both DM and high FIB-4 index had a significantly higher mortality (HR, 9.54; 95% CI, 4.11 to 22.15). Higher FIB-4 indices were associated with higher mortality regardless of DM. A high FIB-4 index with DM was more significantly associated with a severe clinical course with mortality (odds ratio, 11.24; 95% CI, 5.90 to 21.41) than a low FIB-4 index without DM, followed by a high FIB-4 index alone and DM alone. The duration of quarantine and hospital stay also tended to be longer in those with both DM and high FIB-4 index.
Conclusion
Both DM and high FIB-4 index are independent and additive risk factors for COVID-19 mortality.

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Close layer
Thyroid
Thyroid Hormone Profile and Its Prognostic Impact on the Coronavirus Disease 2019 in Korean Patients
Jiyeon Ahn, Min Kyung Lee, Jae Hyuk Lee, Seo Young Sohn
Endocrinol Metab. 2021;36(4):769-777.   Published online August 27, 2021
DOI: https://doi.org/10.3803/EnM.2021.1109
  • 4,913 View
  • 187 Download
  • 18 Web of Science
  • 19 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients.
Methods
The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones.
Results
Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P<0.05). Patients in the lowest T3 tertile (<0.77 ng/mL) had higher rates of mechanical ventilation, intensive care unit admission, and death than those in the middle and highest (>1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile.
Conclusion
Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.

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Special Article
Miscellaneous
COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society
Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim, the Committee of Clinical Practice Guideline of the Korean Endocrine Society
Endocrinol Metab. 2021;36(4):757-765.   Published online August 17, 2021
DOI: https://doi.org/10.3803/EnM.2021.404
  • 11,044 View
  • 422 Download
  • 20 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   ePub   
Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

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Close layer
Original Article
Thyroid
Insights from a Prospective Follow-up of Thyroid Function and Autoimmunity among COVID-19 Survivors
David Tak Wai Lui, Chi Ho Lee, Wing Sun Chow, Alan Chun Hong Lee, Anthony Raymond Tam, Carol Ho Yi Fong, Chun Yiu Law, Eunice Ka Hong Leung, Kelvin Kai Wang To, Kathryn Choon Beng Tan, Yu Cho Woo, Ching Wan Lam, Ivan Fan Ngai Hung, Karen Siu Ling Lam
Endocrinol Metab. 2021;36(3):582-589.   Published online June 8, 2021
DOI: https://doi.org/10.3803/EnM.2021.983
  • 11,660 View
  • 276 Download
  • 34 Web of Science
  • 36 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The occurrence of Graves’ disease and Hashimoto thyroiditis after coronavirus disease 2019 (COVID-19) raised concerns that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger thyroid autoimmunity. We aimed to address the current uncertainties regarding incident thyroid dysfunction and autoimmunity among COVID-19 survivors.
Methods
We included consecutive adult COVID-19 patients without known thyroid disorders, who were admitted to Queen Mary Hospital from July 21 to September 21, 2020 and had serum levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine (fT3), and anti-thyroid antibodies measured both on admission and at 3 months.
Results
In total, 122 patients were included. Among 20 patients with abnormal thyroid function tests (TFTs) on admission (mostly low fT3), 15 recovered. Among 102 patients with initial normal TFTs, two had new-onset abnormalities that could represent different phases of thyroiditis. Among 104 patients whose anti-thyroid antibody titers were reassessed, we observed increases in anti-thyroid peroxidase (TPO) (P<0.001) and anti-thyroglobulin (P<0.001), but not anti-thyroid stimulating hormone receptor titers (P=0.486). Of 82 patients with negative anti-TPO findings at baseline, 16 had a significant interval increase in anti-TPO titer by >12 U, and four became anti-TPO-positive. Worse baseline clinical severity (P=0.018), elevated C-reactive protein during hospitalization (P=0.033), and higher baseline anti-TPO titer (P=0.005) were associated with a significant increase in anti-TPO titer.
Conclusion
Most patients with thyroid dysfunction on admission recovered during convalescence. Abnormal TFTs suggestive of thyroiditis occurred during convalescence, but infrequently. Importantly, our novel observation of an increase in anti-thyroid antibody titers post-COVID-19 warrants further follow-up for incident thyroid dysfunction among COVID-19 survivors.

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Review Article
Diabetes
Continuous Glucose Monitoring in the Hospital
M. Citlalli Perez-Guzman, Trisha Shang, Jennifer Y. Zhang, Donna Jornsay, David C. Klonoff
Endocrinol Metab. 2021;36(2):240-255.   Published online March 31, 2021
DOI: https://doi.org/10.3803/EnM.2021.201
  • 18,081 View
  • 693 Download
  • 28 Web of Science
  • 25 Crossref
AbstractAbstract PDFPubReader   ePub   
Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals. The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. The use of CGMs to automatically and remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease: the amount of necessary nursing exposure to COVID-19 patients with diabetes; the amount of time required for obtaining blood glucose measurements, and the amount of personal protective equipment necessary for interacting with patients during the blood glucose testing. The United States Food and Drug Administration (FDA) is now exercising enforcement discretion and not objecting to certain factory-calibrated CGMs being used in a hospital setting, both to facilitate patient care and to obtain performance data that can be used for future regulatory submissions. CGMs can be used in the hospital to decrease the frequency of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease hypoglycemic episodes. Most of the research on CGMs in the hospital has focused on their accuracy and only recently outcomes data has been reported. A hospital CGM program requires cooperation of physicians, bedside nurses, diabetes educators, and hospital administrators to appropriately select and manage patients. Processes for collecting, reviewing, storing, and responding to CGM data must be established for such a program to be successful. CGM technology is advancing and we expect that CGMs will be increasingly used in the hospital for patients with diabetes.

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Brief Report
Obesity and Metabolism
Overweight and Obesity are Risk Factors for Coronavirus Disease 2019: A Propensity Score-Matched Case-Control Study
Wonjun Ji, Rugyeom Lee, Kyungmin Huh, Minsun Kang, In Cheol Hwang, Munkhzul Radnaabaatar, Dae Ho Lee, Jaehun Jung
Endocrinol Metab. 2021;36(1):196-200.   Published online February 24, 2021
DOI: https://doi.org/10.3803/EnM.2020.856
  • 5,704 View
  • 227 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Although obesity is a risk factor for infection, whether it has the same effect on coronavirus disease 2019 (COVID-19) need confirming. We conducted a retrospective propensity score matched case-control study to examine the association between obesity and COVID-19. This study included data from the Nationwide COVID-19 Registry and the Biennial Health Checkup database, until May 30, 2020. We identified 2,231 patients with confirmed COVID-19 and 10-fold-matched negative test controls. Overweight (body mass index [BMI] 23 to 24.9 kg/m2; adjusted odds ratio [aOR], 1.16; 95% confidence interval [CI], 1.1.03 to 1.30) and class 1 obesity (BMI 25 to 29.9 kg/m2; aOR, 1.27; 95% CI, 1.14 to 1.42) had significantly increased COVID-19 risk, while classes 2 and 3 obesity (BMI ≥30 kg/m2) showed similar but non-significant trend. Females and those <50 years had more robust association pattern. Overweight and obesity are possible risk factors of COVID-19.

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