Endocrinology and Metabolism

Editorial

Thyroid
LC‑MS/MS for Thyroglobulin: A Complementary Approach to Immunoassay Limitations for Thyroid Cancer: Se Hee Park, Dong Yeob Shin; Endocrinol Metab. 2025;40(6):866-868. Published online December 24, 2025; DOI: https://doi.org/10.3803/EnM.2025.2822

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Original Articles

Thyroid
Investigating Birth and Thyroid Outcomes of Maternal-Fetal Environmental Exposures (IBM-E): A Cohort Protocol for Dietary Iodine and Endocrine Disruptors: Yun Ji Jung, Jeong Eun Shin, Ju-hee Yoon, Suhra Kim, Hayan Kwon, Sungbo Shim, Dong Yeob Shin, Minseo Gim, Younglim Kho, JoonHo Lee; Endocrinol Metab. 2025;40(6):940-949. Published online September 25, 2025; DOI: https://doi.org/10.3803/EnM.2025.2475

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Abstract PDF Supplementary Material PubReader ePub: Background
Endocrine-disrupting chemicals (EDCs) are environmental pollutants that may impair maternal and fetal health by disrupting hormonal systems, including the thyroid. Both iodine deficiency and excess are associated with thyroid dysfunction and adverse obstetrical outcomes. However, the combined impacts of EDCs and iodine exposure on maternal-fetal thyroid homeostasis remain undetermined. We established the Investigating Birth and Thyroid Outcomes of Maternal-Fetal Environmental Exposures (IBM-E) cohort to prospectively assess the effects of maternal exposures to dietary iodine and EDCs on thyroid function, pregnancy complications, and offspring growth and development.
Methods
In this prospective observational study, we aim to enroll 556 pregnant women between 2024 and 2027 at a tertiary hospital in Korea. Maternal blood and urine samples will be collected at six time points, spanning from early pregnancy through 15 months postpartum, with infant samples collected at three time points. EDCs will be quantified using ultra-high performance liquid chromatography-tandem mass spectrometry. Thyroid function and urinary iodine concentration will be measured in both mothers and infants.
Results
As of the current interim analyses of 193 mothers and 229 neonates, 15.0% of mothers had thyroid dysfunction and 11.4% developed preeclampsia. Preterm birth occurred in 23.8% of cases, and 16.6% of neonates were small for gestational age.
Conclusion
The IBM-E cohort is designed to enable the longitudinal assessment of gestational environmental exposures and their potential impacts on maternal and fetal thyroid function, as well as pregnancy and neonatal outcomes. The findings of this study may inform preventive strategies and guide policy development in perinatal environmental health.

Thyroid
Prognostic Roles of Inflammatory Biomarkers in Radioiodine-Refractory Thyroid Cancer Treated with Lenvatinib: Chae A Kim, Mijin Kim, Meihua Jin, Hee Kyung Kim, Min Ji Jeon, Dong Jun Lim, Bo Hyun Kim, Ho-Cheol Kang, Won Bae Kim, Dong Yeob Shin, Won Gu Kim; Endocrinol Metab. 2024;39(2):334-343. Published online April 4, 2024; DOI: https://doi.org/10.3803/EnM.2023.1854

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Background
Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), serve as valuable prognostic indicators in various cancers. This multicenter, retrospective cohort study assessed the treatment outcomes of lenvatinib in 71 patients with radioactive iodine (RAI)-refractory thyroid cancer, considering the baseline inflammatory biomarkers.
Methods
This study retrospectively included patients from five tertiary hospitals in Korea whose complete blood counts were available before lenvatinib treatment. Progression-free survival (PFS) and overall survival (OS) were evaluated based on the median value of inflammatory biomarkers.
Results
No significant differences in baseline characteristics were observed among patients grouped according to the inflammatory biomarkers, except for older patients with a higher-than-median NLR (≥2) compared to their counterparts with a lower NLR (P= 0.01). Patients with a higher-than-median NLR had significantly shorter PFS (P=0.02) and OS (P=0.017) than those with a lower NLR. In multivariate analysis, a higher-than-median NLR was significantly associated with poor OS (hazard ratio, 3.0; 95% confidence interval, 1.24 to 7.29; P=0.015). However, neither the LMR nor the PLR was associated with PFS. A higher-than-median LMR (≥3.9) was significantly associated with prolonged OS compared to a lower LMR (P=0.036). In contrast, a higher-than-median PLR (≥142.1) was associated with shorter OS compared to a lower PLR (P=0.039).
Conclusion
Baseline inflammatory biomarkers can serve as predictive indicators of PFS and OS in patients with RAI-refractory thyroid cancer treated with lenvatinib.

Citations

Citations to this article as recorded by

Development and validation of a prognostic model for first-line immunotherapy for metastatic esophageal squamous cell carcinoma
Loulu Gao, Jieqiong Peng, Zixuan Hu, Xiangxue Li, Siyi Zhang, Xiaoxuan Li, Ziheng Zhang, Jing Lv, Jialin Song, Wensheng Qiu
International Immunopharmacology.2026; 168: 115813. CrossRef
Nomogram Model for Prognosis of Distant Metastatic DTC Based on Inflammatory and Clinicopathological Factors
Chenghui Lu, Guoqiang Wang, Zengmei Si, Fengqi Li, Xinfeng Liu, Na Han, Congcong Wang, Jiao Li, Xufu Wang
Journal of the Endocrine Society.2025;[Epub] CrossRef
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Oral Oncology.2025; 168: 107513. CrossRef
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Special Articles

Miscellaneous
Diagnosis and Treatment of Growth Hormone Deficiency: A Position Statement from Korean Endocrine Society and Korean Society of Pediatric Endocrinology: Jung Hee Kim, Hyun Wook Chae, Sang Ouk Chin, Cheol Ryong Ku, Kyeong Hye Park, Dong Jun Lim, Kwang Joon Kim, Jung Soo Lim, Gyuri Kim, Yun Mi Choi, Seong Hee Ahn, Min Ji Jeon, Yul Hwangbo, Ju Hee Lee, Bu Kyung Kim, Yong Jun Choi, Kyung Ae Lee, Seong-Su Moon, Hwa Young Ahn, Hoon Sung Choi, Sang Mo Hong, Dong Yeob Shin, Ji A Seo, Se Hwa Kim, Seungjoon Oh, Sung Hoon Yu, Byung Joon Kim, Choong Ho Shin, Sung-Woon Kim, Chong Hwa Kim, Eun Jig Lee; Endocrinol Metab. 2020;35(2):272-287. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.272

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Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

Citations

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Pedro Iglesias
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Agnese Murianni, Anna Lussu, Chiara Guzzetti, Anastasia Ibba, Letizia Casula, Mariacarolina Salerno, Marco Cappa, Sandro Loche
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The effect of hypothalamic involvement and growth hormone treatment on cardiovascular risk factors during the transition period in patients with childhood-onset craniopharyngioma
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Soo Yeun Sim, Moon Bae Ahn
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Hypothalamus and Pituitary gland
Medical Treatment with Somatostatin Analogues in Acromegaly: Position Statement: Sang Ouk Chin, Cheol Ryong Ku, Byung Joon Kim, Sung-Woon Kim, Kyeong Hye Park, Kee Ho Song, Seungjoon Oh, Hyun Koo Yoon, Eun Jig Lee, Jung Min Lee, Jung Soo Lim, Jung Hee Kim, Kwang Joon Kim, Heung Yong Jin, Dae Jung Kim, Kyung Ae Lee, Seong-Su Moon, Dong Jun Lim, Dong Yeob Shin, Se Hwa Kim, Min Jeong Kwon, Ha Young Kim, Jin Hwa Kim, Dong Sun Kim, Chong Hwa Kim; Endocrinol Metab. 2019;34(1):53-62. Published online March 21, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.1.53

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The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.

Citations

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Surgical treatment and somatostatin experience in growth hormone-secreting pituitary macroadenoma due to novel AIP mutation
Kıymet Karagöz, Emine Şeyma Eken, Gülin Karacan Küçükali, Muhammed Erkan Emrahoğlu, Duygu Düzcan Kilimci, Melikşah Keskin, Erdal Kurnaz, Keziban Aslı Bala, Şule Yeşil, Şükriye Yılmaz, Abdullah Sezer, Şenay Savaş Erdeve
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Hydrogel-fiber-mesh-based 3D cell cultures: A new method for studying pituitary tumors
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Smart Materials in Medicine.2024; 5(2): 281. CrossRef
Differential gene expression and pathway analysis in growth hormone-secreting pituitary tumors according to granulation pattern
Kyungwon Kim, Yeongmin Kim, Se Hoon Kim, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Chang-Myung Oh, Cheol Ryong Ku
Frontiers in Oncology.2024;[Epub] CrossRef
Agonists, Antagonists and Receptors of Somatostatin: Pathophysiological and Therapeutical Implications in Neoplasias
Argyrios Periferakis, Georgios Tsigas, Aristodemos-Theodoros Periferakis, Carla Mihaela Tone, Daria Alexandra Hemes, Konstantinos Periferakis, Lamprini Troumpata, Ioana Anca Badarau, Cristian Scheau, Ana Caruntu, Ilinca Savulescu-Fiedler, Constantin Carun
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Insulin-Like Growth Factor 1 as a Pillar in Acromegaly: From Diagnosis to Long-Term Management
Mi Kyung Kim
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Diagnosis and Management of Acromegaly: A Consensus Statement of the Pituitary Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism
Luís Miguel Cardoso, Pedro Marques, Maria Teresa Pereira, Ana Agapito, Rui Almeida, Sara Amaral, Maria João Bugalho, Maria Begoña Cattoni, Luísa Cortez, Diana Borges Duarte, João Sequeira Duarte, Fernando Fonseca, Leonor Gomes, Inês Manique, Olinda
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Mirjana Doknić
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Evaluation and Management of Bone Health in Patients with Thyroid Diseases: A Position Statement of the Korean Thyroid Association
A Ram Hong, Ho-Cheol Kang
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Growth Hormone Excess: Implications and Management
Suneela Dhaneshwar, Shrishti Shandily, Vatsalya Tiwari
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Revisiting the usefulness of the short acute octreotide test to predict treatment outcomes in acromegaly
Montserrat Marques-Pamies, Joan Gil, Elena Valassi, Marta Hernández, Betina Biagetti, Olga Giménez-Palop, Silvia Martínez, Cristina Carrato, Laura Pons, Rocío Villar-Taibo, Marta Araujo-Castro, Concepción Blanco, Inmaculada Simón, Andreu Simó-Servat, Gemm
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Medical Treatment with Somatostatin Analogues in Acromegaly: Position Statement
Sang Ouk Chin, Cheol Ryong Ku, Byung Joon Kim, Sung-Woon Kim, Kyeong Hye Park, Kee Ho Song, Seungjoon Oh, Hyun Koo Yoon, Eun Jig Lee, Jung Min Lee, Jung Soo Lim, Jung Hee Kim, Kwang Joon Kim, Heung Yong Jin, Dae Jung Kim, Kyung Ae Lee, Seong-Su Moon, Dong
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Letter

Letter: Thyroid Stimulating Hormone Reference Range and Prevalence of Thyroid Dysfunction in the Korean Population: Korea National Health and Nutrition Examination Survey 2013 to 2015 (Endocrinol Metab 2017;32:106-14, Won Gu Kim et al.): Young Ki Lee, Dong Yeob Shin; Endocrinol Metab. 2017;32(2):302-303. Published online June 23, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.302

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Original Article

Thyroid
The Biochemical Prognostic Factors of Subclinical Hypothyroidism: Myung Won Lee, Dong Yeob Shin, Kwang Joon Kim, Sena Hwang, Eun Jig Lee; Endocrinol Metab. 2014;29(2):154-162. Published online June 26, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.2.154

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Background

Patients with subclinical hypothyroidism (SHT) are common in clinical practice. However, the clinical significance of SHT, including prognosis, has not been established. Further clarifying SHT will be critical in devising a management plan and treatment guidelines for SHT patients. Thus, the aim of this study was to investigate the prognostic factors of SHT.

Methods

We reviewed the medical records of Korean patients who visited the endocrinology outpatient clinic of Severance Hospital from January 2008 to September 2012. Newly-diagnosed patients with SHT were selected and reviewed retrospectively. We compared two groups: the SHT maintenance group and the spontaneous improvement group.

Results

The SHT maintenance group and the spontaneous improvement group had initial thyroid-stimulating hormone (TSH) levels that were significantly different (P=0.035). In subanalysis for subjects with TSH levels between 5 to 10 µIU/mL, the spontaneous improvement group showed significantly lower antithyroid peroxidase antibody (anti-TPO-Ab) titer than the SHT maintenance group (P=0.039). Regarding lipid profiles, only triglyceride level, unlike total cholesterol and low density lipoprotein cholesterol, was related to TSH level, which is correlated with the severity of SHT. Diffuse thyroiditis on ultrasonography only contributed to the severity of SHT, not to the prognosis. High sensitivity C-reactive protein and urine iodine excretion, generally regarded as possible prognostic factors, did not show any significant relation with the prognosis and severity of SHT.

Conclusion

Only initial TSH level was a definite prognostic factor of SHT. TPO-Ab titer was also a helpful prognostic factor for SHT in cases with mildly elevated TSH. Other than TSH and TPO-Ab, we were unable to validate biochemical prognostic factors in this retrospective study for Korean SHT patients.

Citations

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Endocrinology and Metabolism.2014; 29(2): 144. CrossRef

Case Reports

A Case of Pituitary Adenoma with Simultaneous Secretion of TSH and GH.: Eun Young Lee, Cheol Ryong Ku, Hyun Min Kim, Woo Kyoung Lee, Jung Soo Lim, Sena Hwang, Do Hwan Kim, Dong Yeob Shin, Eun Jig Lee; Endocrinol Metab. 2011;26(2):160-165. Published online June 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.2.160

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Abstract PDF

Thyrotropin (TSH)-secreting pituitary adenoma is a very rare disease. In one-quarter of patients suffering from this disease, the pituitary tumor secretes other anterior pituitary hormones. Herein, we report a case of pituitary adenoma with simultaneous secretion of TSH and growth hormone (GH). A 34-year-old female visitied local hospital complaining of sweating, intermittent palpitation, and weight loss of 8 kg within 1 year. The patient had undergone trans-sphenoidal surgery 3 years prior for resolution of a TSH and GH co-secreting pituitary adenoma. She had been administered somatostatin analogue prior to visiting our hospital. The patient's GH levels were suppressed to below 1 ng/mL on the 75 g oral glucose tolerance test, and her basal insulin-like growth factor-I (IGF-I) level was within normal range. Thyroid function tests demonstrated increased levels of both free thyroxine and TSH. Sella-MRI revealed pituitary adenoma at the floor of the pituitary fossa, approximately 2 cm in height. Therefore, she was diagnosed with residual TSH-secreting pituitary adenoma. The patient again underwent trans-sphenoidal surgery and entered complete remission, based on hormone levels and MRI findings.

Citations

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Endoscopic Transsphenoidal Surgery of Pituitary Adenomas: Preliminary Results of the Neurosurgery Service of Hospital Cristo Redentor
Gerson Perondi, Afonso Mariante, Fernando Azambuja, Gabriel Frizon Greggianin, Wanderson William dos Santos Dias, Giulia Pinzetta
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery.2023; 42(02): e89. CrossRef
A case of a co-secreting TSH and growth hormone pituitary adenoma presenting with a thyroid nodule
Laura Hamilton Adams, Derick Adams
Endocrinology, Diabetes & Metabolism Case Reports.2018;[Epub] CrossRef

A Case of Graves' Disease Presenting with Chorea.: Cheol Ryong Ku, Hyung Jun Park, Sung Jin Hong, Dong Yeob Shin, Jin Ha Lee, Moon Jae Chung, Mi Ae Cho, Tae Woong Noh, Byung In Lee, Eun Jig Lee; J Korean Endocr Soc. 2008;23(5):342-346. Published online October 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.5.342

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Abstract PDF

Hyperthyroidism is invariably accompanied by nervous system dysfunction. Specifically, irritability, emotional lability, and hyperkinesia are the signs and symptoms most frequently observed. In rare instances, chorea and/or choreoathetosis are associated with hyperthyroidism. Full evaluation for the etiology of chorea is necessary prior to initiating treatment. We recently encountered a 42-year-old female who initially presented with hyperthyroidism and showed subsequent development of progressive generalized chorea. The patient was diagnosed with chorea secondary to Graves' disease after exclusion of other causes of chorea and improved after the initiation of pulse administration of intravenous methylprednisolone sodium succinate (Solu-medrol(R), 1000 mg for 5 days) and oral antithyroid medication. This treatment strategy resulted in the resolution of involuntary movements. The steroid administration was eventually tapered, and the patient has been maintained on antithyroid and steroid therapy with considerable success since the initiation of treatment.

Citations

Citations to this article as recorded by

Unilateral upper limb chorea associated with hyperthyroidism: A case report and literature review
Wei Chen, Bin Wu, Hongna An, Kaiying Zheng, Daming Zhai, Jiahua Zang, Xiaobing Wu
Frontiers in Neurology.2022;[Epub] CrossRef
Anti-Thyroid Peroxidase/Anti-Thyroglobulin Antibody-Related Neurologic Disorder Responsive to Steroids Presenting with Pure Acute Onset Chorea
Ritwik Ghosh, Subhankar Chatterjee, Souvik Dubey, Alak Pandit, Biman Kanti Ray, Julián Benito-León
Tremor and Other Hyperkinetic Movements.2020;[Epub] CrossRef

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