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Volume 31(3); September 2016
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Review Articles
Obesity and Metabolism
The Diabetes Epidemic in Korea
Junghyun Noh
Endocrinol Metab. 2016;31(3):349-353.   Published online August 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.349
  • 6,259 View
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  • 51 Web of Science
  • 53 Crossref
AbstractAbstract PDFPubReader   

Diabetes is one of the foremost public health issues worldwide that can lead to complications in many organ systems, and has become a significant cause of morbidity and mortality in Korea. According to data from the National Health Insurance Service (NHIS), about 2.7 million Koreans (8.0%) aged 30 years or older had type 2 diabetes mellitus (T2DM) in 2013. The prevalence of T2DM increased with age and rose from 5.6% in 2006 to 8.0% in 2013. Using data based on The Health Screening Service of the NHIS, 25% of Korean adults were reported to have prediabetes in 2013. The prevalence of an impaired fasting glucose tended to increase over time from 21.5% in 2006 to 25.0% in 2013. Even though nationwide health screening has been regularly conducted as a public service, the proportion of undiagnosed cases of diabetes was still reported to be on the higher side in the latest study. Based on the results of these epidemic studies, further actions will be needed to effectively implement lifestyle changes on a social level and increase measures for the early detection of diabetes to stem the tide of the epidemic.

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Close layer
Obesity and Metabolism
Insulin Secretory Capacity and Insulin Resistance in Korean Type 2 Diabetes Mellitus Patients
Jong-Dai Kim, Won-Young Lee
Endocrinol Metab. 2016;31(3):354-360.   Published online August 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.354
  • 4,452 View
  • 42 Download
  • 16 Web of Science
  • 16 Crossref
AbstractAbstract PDFPubReader   

It is well known that many Korean patients with type 2 diabetes mellitus (T2DM) were non-obese and had decreased insulin secretion in past. However, during the past three decades, lifestyles in Korea have been westernized. As a result, the prevalence of obesity, the main cause of diabetes has increased. Thus, there is still a question as to whether the main pathophysiology of current Korean T2DM is insulin resistance or an insulin secretion defect. Because various anti-diabetes medications having different mechanisms of action are currently used as therapeutics, it is important to understand which of these factors is the main physiology in the development of diabetes in Koreans. In this review, we review changes in obesity prevalence, insulin resistance and insulin secretion defects in Korean T2DM during three decades.

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Close layer
Obesity and Metabolism
Novel Molecules Regulating Energy Homeostasis: Physiology and Regulation by Macronutrient Intake and Weight Loss
Anna Gavrieli, Christos S. Mantzoros
Endocrinol Metab. 2016;31(3):361-372.   Published online July 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.361
  • 4,512 View
  • 48 Download
  • 16 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   

Excess energy intake, without a compensatory increase of energy expenditure, leads to obesity. Several molecules are involved in energy homeostasis regulation and new ones are being discovered constantly. Appetite regulating hormones such as ghrelin, peptide tyrosine-tyrosine and amylin or incretins such as the gastric inhibitory polypeptide have been studied extensively while other molecules such as fibroblast growth factor 21, chemerin, irisin, secreted frizzle-related protein-4, total bile acids, and heme oxygenase-1 have been linked to energy homeostasis regulation more recently and the specific role of each one of them has not been fully elucidated. This mini review focuses on the above mentioned molecules and discusses them in relation to their regulation by the macronutrient composition of the diet as well as diet-induced weight loss.

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Thyroid
The Revised 2016 Korean Thyroid Association Guidelines for Thyroid Nodules and Cancers: Differences from the 2015 American Thyroid Association Guidelines
Ka Hee Yi
Endocrinol Metab. 2016;31(3):373-378.   Published online September 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.373
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AbstractAbstract PDFPubReader   

Increased detection of thyroid nodules using high-resolution ultrasonography has resulted in a world-wide increase in the incidence of differentiated thyroid cancer (DTC). Despite the steep increase in its incidence, the age-standardized mortality rate of thyroid cancer has remained stable, which leads toward a trend of more conservative treatment. The latest American Thyroid Association (ATA) guidelines for thyroid nodules and thyroid cancer revised in 2015 suggested that fine needle aspiration biopsy should be performed for thyroid nodules larger than 1 cm and lobectomy might be sufficient for 1 to 4 cm intrathyroidal DTC. In addition, active surveillance instead of immediate surgical treatment was also recommended as a treatment option for papillary thyroid microcarcinoma based on the results of a few observational studies from Japan. The Korean Thyroid Association (KTA) has organized a task force team to develop revised guidelines for thyroid nodules and DTC after an extensive review of articles and intense discussion on whether we should accept the changes in the 2015 ATA guidelines. This paper introduces and discusses the updated major issues and differences in the ATA and the KTA guidelines.

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Thyroid
Recent Advances in Autoimmune Thyroid Diseases
Won Sang Yoo, Hyun Kyung Chung
Endocrinol Metab. 2016;31(3):379-385.   Published online August 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.379
  • 5,920 View
  • 124 Download
  • 31 Web of Science
  • 33 Crossref
AbstractAbstract PDFPubReader   

Autoimmune thyroid disease (AITD) includes hyperthyroid Graves disease, hypothyroid autoimmune thyroiditis, and subtle subclinical thyroid dysfunctions. AITD is caused by interactions between genetic and environmental predisposing factors and results in autoimmune deterioration. Data on polymorphisms in the AITD susceptibility genes, related environmental factors, and dysregulation of autoimmune processes have accumulated over time. Over the last decade, there has been progress in the clinical field of AITD with respect to the available diagnostic and therapeutic methods as well as clinical consensus. The updated clinical guidelines allow practitioners to identify the most reasonable and current approaches for proper management. In this review, we focus on recent advances in understanding the genetic and environmental pathogenic mechanisms underlying AITD and introduce the updated set of clinical guidelines for AITD management. We also discuss other aspects of the disease such as management of subclinical thyroid dysfunction, use of levothyroxine plus levotriiodothyronine in the treatment of autoimmune hypothyroidism, risk assessment of long-standing antithyroid drug therapy in recurrent Graves' hyperthyroidism, and future research needs.

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Thyroid
Update on the Management of Thyroid Disease during Pregnancy
Chang Hoon Yim
Endocrinol Metab. 2016;31(3):386-391.   Published online August 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.386
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AbstractAbstract PDFPubReader   

Thyroid dysfunction during pregnancy can result in serious complications for both the mother and infant; however, these complications can be prevented by optimal treatment of maternal overt thyroid dysfunction. Although several studies have demonstrated that maternal subclinical hypothyroidism is associated with obstetric complications and neurocognitive impairments in offspring, there is limited evidence that levothyroxine treatment can improve these complications. Therefore, most professional societies do not recommend universal screening for thyroid dysfunction during pregnancy, and instead recommend a case-finding approach in which only high-risk women are tested. However, recent studies have estimated that targeted thyroid function testing misses approximately 30% to 55% of hypothyroidism cases in pregnant women, and some associations and researchers have recommended universal screening of pregnant women to facilitate the early detection and treatment of overt hypothyroidism. This review summarizes recent data on thyroid function test changes, thyroid functional disorder management, and thyroid screening during pregnancy.

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Recent Updates on the Management of Medullary Thyroid Carcinoma
Bo Hyun Kim, In Joo Kim
Endocrinol Metab. 2016;31(3):392-399.   Published online August 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.392
  • 4,682 View
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AbstractAbstract PDFPubReader   

Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor derived from the thyroid C cells producing calcitonin. MTC accounts for 0.6% of all thyroid cancers and incidence of MTC increased steadily between 1997 and 2011 in Korea. It occurs either sporadically or in a hereditary form based on germline rearranged during transfection (RET) mutations. MTC can be cured only by complete resection of the thyroid tumor and any loco-regional metastases. The most appropriate treatment is still less clear in patients with residual or recurrent disease after initial surgery or those with distant metastases because most patients even with metastatic disease have indolent courses with slow progression for several years and MTC is not responsive to either radioactive iodine therapy or thyroid-stimulating hormone suppression. Recently, two tyrosine kinase inhibitors (TKIs), vandetanib and cabozantinib, are approved for use in patients with advanced, metastatic or progressive MTC. In this review, we summarize the current approach according to revised American Thyroid Association guidelines and recent advances in systemic treatment such as TKIs for patients with persistent or recurrent MTC after surgery.

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    World Journal of Surgery.2017; 41(10): 2551.     CrossRef
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    Nawal A. Alarfaj, Maha F. El-Tohamy
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    Qin Xie, Hui Chen, Jing Ai, Ying-lei Gao, Mei-yu Geng, Jian Ding, Yi Chen
    Acta Pharmacologica Sinica.2017; 38(11): 1533.     CrossRef
  • Articles inEndocrinology and Metabolismin 2016
    Won-Young Lee
    Endocrinology and Metabolism.2017; 32(1): 62.     CrossRef
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Editorial
Bone Metabolism
New Biological Markers of Bone Metabolism in Osteoporosis Treatment
Sun Wook Cho
Endocrinol Metab. 2016;31(3):400-401.   Published online September 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.400
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PDFPubReader   
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Original Articles
Clinical Study
Eligibility for Statin Treatment in Korean Subjects with Reduced Renal Function: An Observational Study
Byung Sub Moon, Jongho Kim, Ji Hyun Kim, Young Youl Hyun, Se Eun Park, Hyung-Geun Oh, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Kyu-Beck Lee, Hyang Kim, Sung-Woo Park, Eun-Jung Rhee
Endocrinol Metab. 2016;31(3):402-409.   Published online August 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.402
  • 3,912 View
  • 33 Download
  • 4 Web of Science
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AbstractAbstract PDFPubReader   
Background

The purpose of this study was to investigate the relationship between statin eligibility and the degree of renal dysfunction using the Adult Treatment Panel (ATP) III and the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines in Korean adults.

Methods

Renal function was assessed in 18,746 participants of the Kangbuk Samsung Health Study from January 2011 to December 2012. Subjects were divided into three groups according to estimated glomerular filtration rate (eGFR): stage 1, eGFR ≥90 mL/min/1.73 m2; stage 2, eGFR 60 to 89 mL/min/1.73 m2; and stages 3 to 5, eGFR <60 mL/min/1.73 m2. Statin eligibility in these groups was determined using the ATP III and ACC/AHA guidelines, and the risk for 10-year atherosclerotic cardiovascular disease (ASCVD) was calculated using the Framingham Risk Score (FRS) and Pooled Cohort Equation (PCE).

Results

There were 3,546 (18.9%) and 4,048 (21.5%) statin-eligible subjects according to ATP III and ACC/AHA guidelines, respectively. The proportion of statin-eligible subjects increased as renal function deteriorated. Statin eligibility by the ACC/AHA guidelines showed better agreement with the Kidney Disease Improving Global Outcomes (KDIGO) recommendations compared to the ATP III guidelines in subjects with stage 3 to 5 chronic kidney disease (CKD) (κ value, 0.689 vs. 0.531). When the 10-year ASCVD risk was assessed using the FRS and PCE, the mean risk calculated by both equations significantly increased as renal function declined.

Conclusions

The proportion of statin-eligible subjects significantly increased according to worsening renal function in this Korean cohort. ACC/AHA guideline showed better agreement for statin eligibility with that recommended by KDIGO guideline compared to ATP III in subjects with CKD.

Citations

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  • Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus
    Honghong Ren, Lijun Zhao, Yutong Zou, Yiting Wang, Junlin Zhang, Yucheng Wu, Rui Zhang, Tingli Wang, Jiali Wang, Yitao Zhu, Ruikun Guo, Huan Xu, Lin Li, Mark E. Cooper, Fang Liu
    Renal Failure.2021; 43(1): 477.     CrossRef
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    Seo Yeon Baik, Hyunah Kim, So Jung Yang, Tong Min Kim, Seung-Hwan Lee, Jae Hyoung Cho, Hyunyong Lee, Hyeon Woo Yim, Kun-Ho Yoon, Hun-Sung Kim
    Frontiers of Medicine.2019; 13(6): 713.     CrossRef
  • Analysis and comparison of the cost-effectiveness of statins according to the baseline low-density lipoprotein cholesterol level in Korea
    Y. J. Jeong, H. Kim, S. J. Baik, T. M. Kim, S. J. Yang, S.-H. Lee, J.-H. Cho, H. Lee, H. W. Yim, I. Y. Choi, K.-H. Yoon, H.-S. Kim
    Journal of Clinical Pharmacy and Therapeutics.2017; 42(3): 292.     CrossRef
  • Comparison between Atorvastatin and Rosuvastatin in Renal Function Decline among Patients with Diabetes
    Eugene Han, Gyuri Kim, Ji-Yeon Lee, Yong-ho Lee, Beom Seok Kim, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang
    Endocrinology and Metabolism.2017; 32(2): 274.     CrossRef
Close layer
Clinical Study
Prevalence of Hyponatremia in Hypothyroid Patients during Radioactive 131I Ablation for Differentiated Thyroid Cancer: Single Institution Experience
Juan Carlo P. Dayrit, Elaine C. Cunanan, Sjoberg A. Kho
Endocrinol Metab. 2016;31(3):410-415.   Published online August 17, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.410
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AbstractAbstract PDFPubReader   
Background

Hyponatremia developing in hypothyroid patients has been encountered in clinical practice; however, its prevalence has not been well established.

Methods

Thirty patients diagnosed with differentiated thyroid cancer, rendered hypothyroid after surgery and levothyroxine withdrawal, and who are for radioactive iodine (RAI) ablation were included. Serum sodium concentrations were measured twice, at the time of admission for RAI ablation, and before discharge after increased oral fluid intake. The outcome measures were to determine the prevalence of hyponatremia among hypothyroid patients prior to RAI ablation and after oral hydration post-RAI, and to correlate the serum sodium levels pre-RAI and post-RAI with thyroid-stimulating hormone (TSH) concentration and age.

Results

Thirty patients were included, with ages from 23 to 65 years old (median, 40). Two patients (6.7%) were hyponatremic prior to RAI ablation, and eight patients (26.7%) had mild hyponatremia (130 to 134 mEq/L) after RAI and hydration. There was no significant correlation between TSH levels and serum sodium levels prior to or after RAI. There was also no significant correlation between pre- and post-RAI sodium concentration and age.

Conclusions

The prevalence of hyponatremia pre-RAI was 6.7%, and 26.7% post-RAI. No significant correlation was noted between TSH concentration and age on pre- or post-RAI sodium concentrations. Routine measurement of serum sodium post-RAI/isolation is still not advised. Measurement of sodium post-RAI may be considered in patients who are elderly, with comorbid conditions or on medications.

Citations

Citations to this article as recorded by  
  • Is there a causal relationship between hypothyroidism and hyponatremia?
    Julie Chen
    Therapeutic Advances in Endocrinology and Metabolism.2023;[Epub]     CrossRef
  • Endocrinopathy-induced euvolemic hyponatremia
    Talia Diker-Cohen, Benaya Rozen-Zvi, Dana Yelin, Amit Akirov, Eyal Robenshtok, Anat Gafter-Gvili, Daniel Shepshelovich
    Internal and Emergency Medicine.2018; 13(5): 679.     CrossRef
Close layer
Clinical Study
Comparison of Age of Onset and Frequency of Diabetic Complications in the Very Elderly Patients with Type 2 Diabetes
Bong-Ki Lee, Sang-Wook Kim, Daehee Choi, Eun-Hee Cho
Endocrinol Metab. 2016;31(3):416-423.   Published online August 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.416
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AbstractAbstract PDFPubReader   
Background

The prevalence of type 2 diabetes in elderly people has increased dramatically in the last few decades. This study was designed to clarify the clinical characteristics of type 2 diabetes in patients aged ≥80 years according to age of onset.

Methods

We reviewed the medical records of 289 patients aged ≥80 years with type 2 diabetes at the outpatient diabetes clinics of Kangwon National University Hospital from September 2010 to June 2014. We divided the patients into middle-age-onset diabetes (onset before 65 years of age) and elderly-onset diabetes (onset at 65+ years of age).

Results

There were 141 male and 148 female patients. The patients had a mean age of 83.2±2.9 years and the mean duration of diabetes was 14.3±10.4 years. One hundred and ninety-nine patients had elderly-onset diabetes. The patients with elderly-onset diabetes had a significantly lower frequency of diabetic retinopathy and nephropathy, lower serum creatinine levels, lower glycated hemoglobin (HbA1c) levels, and similar coronary revascularization and cerebral infarction rates compared to those with middle-age-onset diabetes. There was no frequency difference in coronary revascularization and cerebral infarction and HbA1c levels between three subgroups (<5, 5 to 15, and ≥15 years) of diabetes duration in elderly onset diabetes. However, both in the elderly onset diabetes and middle-age-onset diabetes, the cumulative incidence of retinopathy was increasing rapidly according to the duration of diabetes.

Conclusion

We report that individuals with elderly-onset diabetes have a lower frequency of diabetic retinopathy and nephropathy and similar cardiovascular complications compared to those with middle-age-onset diabetes.

Citations

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    Haejung Lee, Misoon Lee, Gaeun Park, Ah Reum Khang
    Journal of Korean Gerontological Nursing.2022; 24(1): 22.     CrossRef
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    Christine T. Cigolle, Caroline S. Blaum, Chen Lyu, Jinkyung Ha, Mohammed Kabeto, Judy Zhong
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    Alfredo Carrato, Davide Melisi, Gerald Prager, Christoph B Westphalen, Anabel Ferreras, Nathalie D’Esquermes, Julien Taieb, Teresa M Mercadé
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    Avivit Cahn, Talya Altaras, Tal Agami, Ori Liran, Colette E. Touaty, Michel Drahy, Rena Pollack, Itamar Raz, Gabriel Chodick, Inbar Zucker
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  • Response: Comparison of Age of Onset and Frequency of Diabetic Complications in the Very Elderly Patients with Type 2 Diabetes (Endocrinol Metab2016;31:416-23, Bong-Ki Lee et al.)
    Eun-Hee Cho
    Endocrinology and Metabolism.2017; 32(1): 142.     CrossRef
  • Letter: Comparison of Age of Onset and Frequency of Diabetic Complications in the Very Elderly Patients with Type 2 Diabetes (Endocrinol Metab2016;31:416-23, Bong-Ki Lee et al.)
    Mee Kyoung Kim
    Endocrinology and Metabolism.2017; 32(1): 140.     CrossRef
Close layer
Clinical Study
Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis
Avinash Agarwal, Ambuj Yadav, Manish Gutch, Shuchi Consul, Sukriti Kumar, Ved Prakash, Anil Kumar Gupta, Annesh Bhattacharjee
Endocrinol Metab. 2016;31(3):424-432.   Published online September 1, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.424
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AbstractAbstract PDFPubReader   
Background

Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical and biochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity and mortality.

Methods

Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically and by laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted as either discharged to home or death.

Results

The analysis indicated that significant predictors included sex, history of type 1 diabetes mellitus or type 2 diabetes mellitus, systolic blood pressure, diastolic blood pressure, total leukocyte count, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, blood urea nitrogen, serum creatinine, serum magnesium, serum phosphate, serum osmolality, serum glutamic oxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected to multivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorable outcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in mean APACHE II score (14.83) and serum phosphate (4.38) at presentation may lead to 2.86- and 2.71-fold better outcomes, respectively, compared with higher levels (APACHE II score, 25.00; serum phosphate, 6.04).

Conclusion

Sex, baseline biochemical parameters such as APACHE II score, and phosphate level were important predictors of the DKA-associated mortality.

Citations

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    Tracey Sainsbury
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    Orighomisan F Agboghoroma, Modou Jobe, Karen Forrest
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    Qiaoling Liu, Chen Gong, Yunjie Geng, Jiuhong You
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    Sunetra Mondal, Riddhi DasGupta, Moushumi Lodh, Ashok Parida, Mandira Haldar, Arunangshu Ganguly
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    Ashok Kumar Pannu, Ravindran Kiran, Abhishek Kumar, Saurabh Chandrabhan Sharda, Mandip Bhatia, Atul Saroch, Pinaki Dutta, Navneet Sharma
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    M. Saini, J. Kaur
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    Ketan K. Dhatariya
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Close layer
Clinical Study
Osteoporosis and Prevalent Fractures among Adult Filipino Men Screened for Bone Mineral Density in a Tertiary Hospital
Erick S. Mendoza, Amy A. Lopez, Valerie Ann U. Valdez, Leilani B. Mercado-Asis
Endocrinol Metab. 2016;31(3):433-438.   Published online August 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.433
  • 4,365 View
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AbstractAbstract PDFPubReader   
Background

Osteoporosis in men is markedly underdiagnosed and undertreated despite higher morbidity and mortality associated with fractures. This study aimed to characterize adult Filipino men with osteopenia, osteoporosis and prevalent fractures.

Methods

A cross-sectional study of 184 Filipino men ≥50 years screened for bone mineral density was performed. Age, weight, body mass index (BMI), Osteoporosis Self-Assessment Tool for Asians (OSTA) score, smoking status, family history of fracture, diabetes mellitus, physical inactivity, and T-score were considered.

Results

Of the 184 patients, 40.2% and 29.9% have osteopenia and osteoporosis. Sixteen (21.6%) and 18 (32.1%) osteopenic and osteoporotic men have fragility hip, spine, or forearm fractures. Men aged 50 to 69 years have the same risk of osteoporosis and fractures as those ≥70 years. While hip fractures are higher in osteoporotic men, vertebral fractures are increased in both osteopenic and osteoporotic men. Mere osteopenia predicts the presence of prevalent fractures. A high risk OSTA score can predict fracture. A BMI <21 kg/m2 (P<0.05) and current smoking are associated with osteoporosis.

Conclusion

A significant fraction of Filipino men with osteopenia and osteoporosis have prevalent fractures. Our data suggest that fractures occur in men <70 years even before osteoporosis sets in. Low BMI, high OSTA score, and smoking are significant risk factors of osteoporosis.

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    Chin Kwang Chong, Wei Ting Chua, Susie Ling Yii Wong, Tat Yean Tham
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    Won-Young Lee
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Close layer
Clinical Study
Correlation of Glypican-4 Level with Basal Active Glucagon-Like Peptide 1 Level in Patients with Type 2 Diabetes Mellitus
Sang Ah Lee, Gwanpyo Koh, Suk Ju Cho, So-Yeon Yoo, Sang Ouk Chin
Endocrinol Metab. 2016;31(3):439-445.   Published online September 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.439
  • 4,028 View
  • 41 Download
  • 8 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Previous studies have reported that glypican-4 (GPC4) regulates insulin signaling by interacting with insulin receptor and through adipocyte differentiation. However, GPC4 has not been studied with regard to its effects on clinical factors in patients with type 2 diabetes mellitus (T2DM). We aimed to identify factors associated with GPC4 level in T2DM.

Methods

Between January 2010 and December 2013, we selected 152 subjects with T2DM and collected serum and plasma into tubes pretreated with aprotinin and dipeptidyl peptidase-4 inhibitor to preserve active gastric inhibitory polypeptide (GIP) and glucagon-like peptide 1 (GLP-1). GPC4, active GLP-1, active GIP, and other factors were measured in these plasma samples. We performed a linear regression analysis to identify factors associated with GPC4 level.

Results

The subjects had a mean age of 58.1 years, were mildly obese (mean body mass index [BMI], 26.1 kg/m2), had T2DM of long-duration (mean, 101.3 months), glycated hemoglobin 7.5%, low insulin secretion, and low insulin resistance (mean homeostatic model assessment of insulin resistance [HOMA-IR], 1.2). Their mean GPC4 was 2.0±0.2 ng/mL. In multivariate analysis, GPC4 was independently associated with age (β=0.224, P=0.009), and levels of active GLP-1 (β=0.171, P=0.049) and aspartate aminotransferase (AST; β=–0.176, P=0.043) after being adjusted for other clinical factors.

Conclusion

GPC4 was independently associated with age, active GLP-1, and AST in T2DM patients, but was not associated with HOMA-IR and BMI, which are well known factors related to GPC4. Further study is needed to identify the mechanisms of the association between GPC4 and basal active GLP-1 levels.

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    Joseph P. Buhl, Antje Garten, Jürgen Kratzsch, Wieland Kiess, Melanie Penke
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Clinical Study
Prevalence of Reduced Kidney Function by Estimated Glomerular Filtration Rate Using an Equation Based on Creatinine and Cystatin C in Metabolic Syndrome and Its Components in Korean Adults
Yang Ho Kang, Dong Wook Jeong, Seok Man Son
Endocrinol Metab. 2016;31(3):446-453.   Published online August 2, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.446
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AbstractAbstract PDFPubReader   
Background

It is known that metabolic syndrome (MetS) is associated with chronic kidney disease. We evaluated and compared the prevalence of reduced kidney function in MetS and its components by estimated glomerular filtration rate (eGFR) using an equation based on creatinine (eGFRcr), cystatin C (eGFRcys), and combined creatinine-cystatin C (eGFRcr-cys) in Korean adults.

Methods

We analyzed data from 3,649 adults who participated in a comprehensive health examination.

Results

Mean values of eGFRcys were higher compared with mean values of eGFRcr (96.1±18.2 mL/min/1.73 m2 vs. 91.2±13.6 mL/min/1.73 m2) in total subjects. The prevalence of reduced kidney function increased with age (9.6% for eGFRcys vs. 5.8% for eGFRcr-cys vs. 4.9% for eGFRcr, in subjects aged ≥60 years), and significantly increased with MetS, abdominal obesity, hypertension, high triglyceride, low high density lipoprotein (HDL), and high insulin resistance. The prevalence of MetS, abdominal obesity, hypertension, high insulin resistance, low HDL, and hepatic steatosis was significantly increased in subjects with reduced kidney function. This increased prevalence and the odds ratio of reduced kidney function for prevalence of MetS was highest for eGFRcys, followed by those of eGFRcr-cys, and eGFRcr.

Conclusion

The prevalence of reduced kidney function by eGFR was significantly increased in subjects with MetS and its related components. eGFRcys and eGFRcr-cys were superior to eGFRcr in detecting reduced kidney function.

Citations

Citations to this article as recorded by  
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