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22 "Dong-Jun Lim"
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Special Article
Hypothalamus and pituitary gland
Consensus on the Diagnosis of Cushing’s Disease: A Collaborative Statement from the Korean Endocrine Society and Japan Endocrine Society
Jeongmin Lee, Hidenori Fukuoka, Seung Shin Park, A Ram Hong, Jung Hee Kim, Sang Ouk Chin, Han-Sang Baek, Dong-Jun Lim, Kazunori Kageyama, Mitsuru Nishiyama, Shigeyuki Tahara, Kenichi Oyama, Akira Sugawara, Miho Yamashita, Naoko Inoshita, Hiroshi Arima, Byung-Joon Kim, Yoon-Sok Chung, Soon Jib Yoo, Michio Otsuki, Mi-kyung Kim, The Committee of Clinical Practice Guideline of Korean Endocrine Society, Korean Neuroendocrine Study Group of Korean Endocrine Society
Endocrinol Metab. 2026;41(1):1-13.   Published online January 1, 2026
DOI: https://doi.org/10.3803/EnM.2025.2707
  • 3,306 View
  • 273 Download
AbstractAbstract PDFPubReader   ePub   
Cushing’s disease (CD) is a rare but serious endocrine disorder caused by excessive cortisol secretion due to adrenocorticotropic hormone–secreting pituitary tumors. Despite recent developments in diagnostic criteria and treatment options, CD remains associated with substantial comorbidities and mortality. Early and accurate diagnosis is thus essential. Both the Korean Endocrine Society (KES) and Japan Endocrine Society (JES) guidelines are intended to standardize diagnostic approaches to CD, and they share common principles; however, notable differences exist, particularly in biochemical testing thresholds and imaging recommendations. This consensus statement integrates clinical evidence and expert practice from both the KES and JES to establish harmonized recommendations for biochemical evaluation, imaging, and differential testing. This unified framework is intended to enhance diagnostic precision and improve clinical outcomes across East Asian populations.
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Review Articles
Thyroid
The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline
Shinje Moon, Young Shin Song, Kyong Yeun Jung, Eun Kyung Lee, Jeongmin Lee, Dong-Jun Lim, Chan Kwon Jung, Young Joo Park, on Behalf of the Korean Thyroid Association Clinical Guideline Committee
Endocrinol Metab. 2025;40(3):357-384.   Published online June 24, 2025
DOI: https://doi.org/10.3803/EnM.2025.2465
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  • 246 Download
  • 5 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
In 2024, the Korean Thyroid Association (KTA) introduced a revised Risk Stratification System (K-RSS) for differentiated thyroid cancer, building upon the modified RSS (M-RSS) proposed by the American Thyroid Association in 2015. The K-RSS emphasizes the cumulative impact of coexisting clinical and pathological features, acknowledging that multiple intermediate-risk factors collectively indicate a higher recurrence risk. Histologic classification follows the 2022 World Health Organization classification, consolidating encapsulated follicular-patterned thyroid carcinomas, including invasive encapsulated follicular variant papillary thyroid carcinoma, follicular thyroid carcinoma, and oncocytic carcinoma of the thyroid gland, and stratifying them by the extent of capsular and vascular invasion. High-grade thyroid carcinoma is newly included. Updated criteria for tumor size and extrathyroidal extension (ETE) represent another significant change. BRAFV600E-mutated papillary thyroid carcinomas measuring 1 to 2 cm are now considered lower risk than previously classified in the M-RSS, while encapsulated follicular-patterned tumors larger than 4 cm are considered higher risk. Both minimal ETE and gross ETE confined to the strap muscles have been downgraded to low and intermediate risk, respectively. These changes are accompanied by updates regarding molecular profiling and surgical margin status. Collectively, these updates aim to minimize overtreatment in low-risk patients, while ensuring intensified management for those at higher risk.

Citations

Citations to this article as recorded by  
  • Development and validation of a machine learning model for predicting high-risk distant metastatic recurrence in differentiated thyroid cancer
    Fei Yang, Jie Zhang, Tengfei Liu, Zhijun Zhao
    Frontiers in Medicine.2026;[Epub]     CrossRef
  • Impact of Tumor Bilaterality and Multifocality in Predicting Recurrence of Papillary Thyroid Carcinoma: A Retrospective Cohort Study
    Eunji Kim, Jun Hyun Park, Ji-Young Park, Jin Hyang Jung, Sang-Woo Lee
    Endocrinology and Metabolism.2026; 41(2): 288.     CrossRef
  • Positive prognostic implications of SPHK1 expression in patients with papillary thyroid carcinoma undergoing radioactive iodine therapy
    Kyung Won Park, Ja Seong Bae, Dong-Jun Lim, Chan Kwon Jung
    Scientific Reports.2026;[Epub]     CrossRef
  • Overdiagnosis and Overtreatment of Thyroid Cancer and Precision Mitigation Strategies—An Integrated Analysis Based on Evidence-Based Medicine and Risk Stratification Models
    云菲 李
    Advances in Clinical Medicine.2026; 16(04): 4980.     CrossRef
  • Who Really Needs RAI Ablation Therapy for Low-to-Intermediate Risk Differentiated Thyroid Cancer? Insights from the IoN Trial
    Young Joo Park
    Clinical Thyroidology®.2025; 37(9): 323.     CrossRef
  • From Classification to Personalization: Advances in Thyroid Cancer Risk Stratification Systems
    Mijin Kim, Bo Hyun Kim
    Endocrinology and Metabolism.2025; 40(5): 689.     CrossRef
  • Thyroglobulin Cutoffs after Total Thyroidectomy Without Radioiodine in Low- to Intermediate-Risk Thyroid Cancer: A Multicenter Cohort Study
    Mijin Kim, Eun Kyung Lee, Kyeong Jin Kim, Soo Myoung Shin, Jinsun Jang, Je Yoon Shin, Meihua Jin, Ja Seong Bae, Kwangsoon Kim, Won Gu Kim, Min Ji Jeon, Seung Heon Kang, Hee Kyung Kim, Jee Hee Yoon, Yea Eun Kang, Hwa Young Ahn, Young Joo Park, Bo Hyun Kim
    Thyroid®.2025;[Epub]     CrossRef
  • Diagnostic Challenges, Prognostic Assessment, and Treatment Strategies in High-Grade Differentiated Thyroid Carcinoma
    Chan Kwon Jung, Agnes Stephanie Harahap
    Endocrinology and Metabolism.2025; 40(6): 830.     CrossRef
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Thyroid
2025 Korean Thyroid Association Management Guidelines for Radioactive Iodine Therapy in Patients with Hyperthyroidism
Kyeong Jin Kim, Eyun Song, Mijin Kim, Hyemi Kwon, Eu Jeong Ku, Hyun Woo Kwon, Jee Hee Yoon, Eun Kyung Lee, Won Woo Lee, Young Joo Park, Dong-Jun Lim, Sun Wook Kim, Ho-Cheol Kang, Jae Hoon Chung, Tae Yong Kim, Sin Gon Kim, Dong Gyu Na, Jee Soo Kim
Endocrinol Metab. 2025;40(3):342-356.   Published online June 24, 2025
DOI: https://doi.org/10.3803/EnM.2025.2464
  • 12,957 View
  • 442 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFPubReader   ePub   
Hyperthyroidism is a condition marked by excessive thyroid hormone production, most commonly due to Graves’ disease. Treatment options include antithyroid drugs (ATD), radioactive iodine (RAI) therapy, and thyroidectomy. To develop standardized clinical recommendations for RAI therapy with a focus on safety, efficacy, and monitoring, the Korean Thyroid Association formed a task force to create evidence-based guidelines. Six key clinical questions were identified through expert consensus, and a systematic literature review from 2013 to 2022 was conducted. Clinical indications for RAI therapy were categorized into three groups: strongly recommended, may be considered, and not recommended. A fixed dose of 10 to 15 mCi is recommended. Although a strict low-iodine diet is unnecessary, iodine-rich foods should be avoided for at least 1 week before treatment. ATD should be stopped 3 to 7 days before RAI and may be resumed in select cases. Prophylactic glucocorticoids are recommended for patients with mildly active thyroid eye disease and may be considered for others at risk. Thyroid function should be monitored at 4–6 weeks post-treatment, every 2–3 months until stabilized, and then every 6–12 months. These guidelines highlight recent advances and underscore the importance of individualized treatment based on clinical features, comorbidities, and patient preferences in Korea.

Citations

Citations to this article as recorded by  
  • Outcome of MRI-Guided Single-Dose Iodine-131 for Graves’ Hyperthyroidism with Large Goiter
    Shangcheng Yan, Xiansheng Chen, Bing Yan, Xin Li, Zhen Cao, Pan Zhang, Yajun Wang, Wenmei Guo, Ziwen Liu
    Annals of Nuclear Medicine.2026;[Epub]     CrossRef
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Thyroid
2025 Korean Thyroid Association Clinical Management Guideline on Active Surveillance for Low-Risk Papillary Thyroid Carcinoma
Eun Kyung Lee, Min Joo Kim, Seung Heon Kang, Bon Seok Koo, Kyungsik Kim, Mijin Kim, Bo Hyun Kim, Ji-hoon Kim, Shinje Moon, Kyorim Back, Young Shin Song, Jong-hyuk Ahn, Hwa Young Ahn, Ho-Ryun Won, Won Sang Yoo, Min Kyoung Lee, Jeongmin Lee, Ji Ye Lee, Kyong Yeun Jung, Chan Kwon Jung, Yoon Young Cho, Dong-Jun Lim, Sun Wook Kim, Young Joo Park, Dong Gyu Na, Jee Soo Kim
Endocrinol Metab. 2025;40(3):307-341.   Published online June 24, 2025
DOI: https://doi.org/10.3803/EnM.2025.2461
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  • 531 Download
  • 5 Web of Science
  • 7 Crossref
AbstractAbstract PDFPubReader   ePub   
The increasing detection of papillary thyroid microcarcinoma (PTMC) has raised concerns regarding overtreatment. For low-risk PTMC, either immediate surgery or active surveillance (AS) can be considered. To facilitate the implementation of AS, the Korean Thyroid Association convened a multidisciplinary panel and developed the first Korean guideline. AS is recommended for adults with pathologically confirmed Bethesda V–VI PTMC who have no clinical evidence of lymph node or distant metastasis, gross extrathyroidal extension, invasion of the trachea or recurrent laryngeal nerve, or aggressive histology. A baseline assessment requires high-resolution neck ultrasound performed by experienced operators to exclude extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, and lymph node metastasis; contrast-enhanced neck computed tomography is optional. Patient characteristics, including age, comorbidities, and the capacity for long-term follow-up, should be thoroughly assessed. Shared decision-making should carefully weigh the benefits and risks of surgery versus AS, considering expected oncologic outcomes, potential complications, quality of life, anxiety, medical costs, and patient preference. Follow-up involves neck ultrasound and thyroid function tests every 6 months for 2 years and annually thereafter. Disease progression, defined as significant tumor growth or newly detected nodal or distant metastasis, warrants surgery. Despite remaining uncertainties, this guideline provides a structured framework to ensure oncologic safety and supports patient-centered AS.

Citations

Citations to this article as recorded by  
  • Feasibility and Safety of Active Surveillance in Subcapsular Thyroid Nodules with High Suspicion for Malignancy
    Yan Hu, Wei Zhou, Lu Zhang, Weiwei Zhan
    Ultrasound in Medicine & Biology.2026; 52(4): 816.     CrossRef
  • Combined Ultrasound and MRI Assessment in Patients Undergoing Reoperation for Recurrent Papillary Thyroid Carcinoma: Oncological Outcomes and Surgical Safety
    Zimei Tang, Jie Liu, Rong Wang, Gang Tian, Anwen Ren, Jiexiao Li, Yiran Wang, Wen Yang, Peng Sun, Tao Huang, Ximeng Zhang, Jie Ming
    Current Oncology.2026; 33(2): 98.     CrossRef
  • Multidisciplinary team diagnosis and treatment of well-differentiated thyroid carcinoma: current landscape and future prospects
    Yuanyuan Li, Peijie Wang, Jiaxin Cao, Haiyan Liu
    The Oncologist.2026;[Epub]     CrossRef
  • Controlled minimally invasive surgical interventions for the treatment of patients with thyroid carcinoma
    David D. Dolidze, Zurab A. Bagatelia, Suren G. Laboyan, Arshak V. Vardanyan, Konstantin S. Titov, Ivan N. Lebedinsky, Georgi Genadi Melkonyan, Dmitriy V. Matveev, Nodar N. Gogitidze, Andrei Y. Lukin, Armen R. Oganyan, David G. Gogolashvili, Anastasia V. B
    Journal of Experimental and Clinical Surgery.2026; 19(1): 45.     CrossRef
  • Overdiagnosis and Overtreatment of Thyroid Cancer and Precision Mitigation Strategies—An Integrated Analysis Based on Evidence-Based Medicine and Risk Stratification Models
    云菲 李
    Advances in Clinical Medicine.2026; 16(04): 4980.     CrossRef
  • Optimal cutoff value of fine-needle aspiration thyroglobulin of metastatic lymph node in thyroid cancer patients
    Yang Yang, Xianfeng Jiang
    European Journal of Surgical Oncology.2025; 51(11): 110428.     CrossRef
  • Low-risk thyroid cancer: surgery or active surveillance—an application of shared decision-making: a narrative review
    Min Joo Kim, Eun Kyung Lee, Sun Wook Cho, Yoo Hyung Kim, Kyu Eun Lee, Su-jin Kim, Woochul Kim, Eun-Jae Chung, Jungirl Seok, Yul Hwangbo, Young Ki Lee, Jinsun Jang, Junsun Ryu, Yuh-Seog Jung, Chang Hwan Ryu, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, K
    Journal of the Korean Medical Association.2025; 68(9): 573.     CrossRef
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Original Articles
Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
Association between the Triglyceride-Glucose Index and Cardiovascular Risk and Mortality across Different Diabetes Durations: A Nationwide Cohort Study
Jeongeun Kwak, Kyung-Do Han, Eun Young Lee, Seung-Hwan Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Jeongmin Lee
Endocrinol Metab. 2025;40(4):548-560.   Published online March 5, 2025
DOI: https://doi.org/10.3803/EnM.2024.2205
  • 6,329 View
  • 248 Download
  • 8 Web of Science
  • 9 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We aimed to assess the association between triglyceride-glucose (TyG) index and cardiovascular disease (CVD) risk and mortality in a large cohort of diabetes patients.
Methods
A retrospective cohort study of 1,090,485 participants from the Korean National Health Insurance Service database was conducted. Participants were stratified into TyG quartiles.
Results
Higher TyG index quartiles were significantly associated with an increased CVD risk and mortality risk. In fully adjusted models, participants in the highest TyG quartile (Q4) had an 18% higher risk of CVD (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.13 to 1.23) and a 16% higher risk of mortality (HR, 1.16; 95% CI, 1.11 to 1.23) compared to those in the lowest quartile (Q1). The association was particularly pronounced in patients with fasting glucose ≥126 mg/dL (CVD [HR, 1.33; 95% CI, 1.29 to 1.37], mortality [HR, 1.23; 95% CI, 1.20 to 1.26]; P for interaction <0.001). Patients with a diabetes duration of ≥10 years showed the strongest association between the TyG index and CVD risk (HR, 1.44; 95% CI, 1.38 to 1.50), while the mortality risk was particularly elevated in those with a diabetes duration of less than 5 years (HR, 1.23; 95% CI, 1.18 to 1.30). Subgroup analyses revealed stronger associations between TyG index and CVD risk in younger participants, non-obese individuals, and non-smokers.
Conclusion
The TyG index is a significant predictor of CVD and mortality in diabetic patients, particularly in those with poor glycemic control or longer disease duration.

Citations

Citations to this article as recorded by  
  • Preoperative triglyceride–glucose index as a metabolic predictor of surgical site infection after posterior lumbar fusion
    Yu Hua, Shaoxing Li, Yuan Jiang, Jinwang Liu
    Journal of Orthopaedic Surgery.2026;[Epub]     CrossRef
  • Combined effect of triglyceride-glucose index and glucose disposal rate on cardio-cerebrovascular disease
    Hongfei Yang, Chao Sun, Ya Li, You Zhou, Rui Wang, Yingxue Li, Marwan Salih Al-Nimer
    PLOS One.2026; 21(2): e0342154.     CrossRef
  • The association between insulin resistance indices and the occurrence of major adverse cardiovascular events in patients with premature myocardial infarction: a prospective cohort study
    Yu Zhou, Yuhang Wang, Jingxi Chen, Lai Jiang, Ran Chu, Weiwei Tian, Jiaxin Wang, Yin Liu, Jing Gao
    Frontiers in Nutrition.2026;[Epub]     CrossRef
  • Current evidence on lipid ratios for cardiovascular risk assessment in diabetes: A review
    E. Carretero-Anibarro, D. Orozco-Beltran
    Primary Care Diabetes.2026;[Epub]     CrossRef
  • Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
    Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
    Diabetologia.2026;[Epub]     CrossRef
  • Analysis of the prevalence of dyslipidemia in early-onset schizophrenia patients and its correlation with clinical characteristics
    Kehuang Li, Zhiwei Liu, Liang Sun, Jingjing Zhang, Xinglong Yin, Zhaokun Zhang, Changjie Cao
    Frontiers in Psychiatry.2026;[Epub]     CrossRef
  • The Triglyceride-Glucose Index: A Practical Tool for Enhanced Cardiovascular Risk Stratification in Type 2 Diabetes
    Jang Won Son
    Endocrinology and Metabolism.2025; 40(4): 545.     CrossRef
  • The association between triglyceride-glucose index and all-cause/cardiovascular mortality in patients with different glucose metabolism statuses
    Jiajun Liu, Jinhua Kang, Pengpeng Liang, Zhangxiao Song, Guiyun Li, Xueshan Jin, Hongyan Wu
    Cardiovascular Diabetology.2025;[Epub]     CrossRef
  • Standardized Triglyceride-Glucose and Plasma Atherogenic Indices as Predictors of Diabetic Nephropathy and Coronary Artery Disease in Patients with Type 1 Diabetes Mellitus
    Nazif Yalçın, Nizameddin Koca
    European Journal of Therapeutics.2025; 32(1): 1.     CrossRef
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Thyroid
Microvascular Ultrasonography Vascularity Index as a Rapid and Simplified Assessment Tool for Differentiating Graves’ Disease from Destructive Thyroiditis and Managing Thyrotoxicosis
Han-Sang Baek, Chaiho Jeong, Jeonghoon Ha, Dong-Jun Lim
Endocrinol Metab. 2025;40(3):394-404.   Published online February 25, 2025
DOI: https://doi.org/10.3803/EnM.2024.2206
  • 3,352 View
  • 90 Download
  • 1 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Background
Thyrotoxicosis presents significant diagnostic challenges in distinguishing Graves’ disease (GD) from destruction-induced thyrotoxicosis (DT) using ultrasound imaging. We evaluated a new technology, microvascular ultrasonography (MVUS) to effectively differentiate between GD and DT, and observe the MVUS changes during follow-up.
Methods
A total of 264 consecutive patients were prospectively enrolled into two cohorts from August 2022 to March 2024 at one tertiary referral hospital: cohort 1 comprised patients initially presenting with thyrotoxicosis (n=185; 98 with GD and 87 with DT). Cohort 2 included patients either with GD considering antithyroid drug discontinuation or with DT in the follow-up phase after treatment (n=77). Ultrasound imaging was conducted using the MVUS technique, and the vascularity index (MVUS-VI) was automatically calculated as the percentage ratio of color pixels to total grayscale pixels within a specified region of interest.
Results
Diagnostic accuracy highlighted MVUS-VI as the most accurate diagnostic tool, achieving a sensitivity of 79.6%, specificity of 84.3%, with an area under the curve of 0.856 (95% confidence interval, 0.800 to 0.911). Presence of thyroid peroxidase antibody or thyroglobulin antibody affected MVUS-VI’s performance, requiring a higher cut-off value for specificity in this subgroup. Follow-up in cohort 2 (n=77) demonstrated significant normalization in thyroid function and reductions in MVUS-VI from an initial 32.6%±23.4% to 20.8%±13.5% at follow-up (P<0.001).
Conclusion
MVUS-VI provides a rapid, non-invasive diagnostic alternative to traditional methods in differentiating GD from DT, thus aiding in the management of patients with thyrotoxicosis.

Citations

Citations to this article as recorded by  
  • Update on newer ultrasound systems to study the microvasculature
    Orlando Catalano, Antonio Pio Masciotra
    La radiologia medica.2025; 130(8): 1283.     CrossRef
  • Diagnostic Approach and Therapeutic Strategies for Ambiguous Thyrotoxicosis
    Mijin Kim
    The Korean Journal of Medicine.2025; 100(5): 241.     CrossRef
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Thyroid
Deep Learning Technology for Classification of Thyroid Nodules Using Multi-View Ultrasound Images: Potential Benefits and Challenges in Clinical Application
Jinyoung Kim, Min-Hee Kim, Dong-Jun Lim, Hankyeol Lee, Jae Jun Lee, Hyuk-Sang Kwon, Mee Kyoung Kim, Ki-Ho Song, Tae-Jung Kim, So Lyung Jung, Yong Oh Lee, Ki-Hyun Baek
Endocrinol Metab. 2025;40(2):216-224.   Published online January 13, 2025
DOI: https://doi.org/10.3803/EnM.2024.2058
  • 9,743 View
  • 284 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to evaluate the applicability of deep learning technology to thyroid ultrasound images for classification of thyroid nodules.
Methods
This retrospective analysis included ultrasound images of patients with thyroid nodules investigated by fine-needle aspiration at the thyroid clinic of a single center from April 2010 to September 2012. Thyroid nodules with cytopathologic results of Bethesda category V (suspicious for malignancy) or VI (malignant) were defined as thyroid cancer. Multiple deep learning algorithms based on convolutional neural networks (CNNs) —ResNet, DenseNet, and EfficientNet—were utilized, and Siamese neural networks facilitated multi-view analysis of paired transverse and longitudinal ultrasound images.
Results
Among 1,048 analyzed thyroid nodules from 943 patients, 306 (29%) were identified as thyroid cancer. In a subgroup analysis of transverse and longitudinal images, longitudinal images showed superior prediction ability. Multi-view modeling, based on paired transverse and longitudinal images, significantly improved the model performance; with an accuracy of 0.82 (95% confidence intervals [CI], 0.80 to 0.86) with ResNet50, 0.83 (95% CI, 0.83 to 0.88) with DenseNet201, and 0.81 (95% CI, 0.79 to 0.84) with EfficientNetv2_ s. Training with high-resolution images obtained using the latest equipment tended to improve model performance in association with increased sensitivity.
Conclusion
CNN algorithms applied to ultrasound images demonstrated substantial accuracy in thyroid nodule classification, indicating their potential as valuable tools for diagnosing thyroid cancer. However, in real-world clinical settings, it is important to aware that model performance may vary depending on the quality of images acquired by different physicians and imaging devices.

Citations

Citations to this article as recorded by  
  • Molecular intelligence and immune reconnaissance in thyroid cancer: a new paradigm for diagnosis, risk stratification, and therapeutic precision
    Marcio J. Concepción-Zavaleta, Jenyfer M. Fuentes-Mendoza, Alfredo Cruz-Quintá, Argelia V. Cadena-Guerrero, Ximena Barrón, Luis Concepción-Urteaga, Cristian D. Armas, José Paz-Ibarra, Juan Eduardo Quiroz-Aldave
    Expert Review of Anticancer Therapy.2026; 26(5): 585.     CrossRef
  • Deep Learning for Ultrasound Classification to Identify Noninvasive Follicular Thyroid Neoplasms with Papillary–Like Nuclear Features
    I-Hung Chien, Yi-Chiung Hsu, Shih-Ping Cheng
    Journal of Imaging Informatics in Medicine.2026;[Epub]     CrossRef
  • Knowledge-Prompted Trustworthy Disentangled Learning for Thyroid Ultrasound Segmentation With Limited Annotations
    Wenxu Wang, Weizhen Wang, Qianjin Feng, Yu Zhang, Zhenyuan Ning
    IEEE Transactions on Image Processing.2026; 35: 983.     CrossRef
  • Integrating Robotic Bilateral Axillo-Breast Approach Thyroidectomy with Molecular Diagnostics and Artificial Intelligence in Thyroid Cancer Care
    Qiang Deng, Xiaoping Men, Duo Jin, Yuzhuo Bai
    Biomolecules & Therapeutics.2026; 34(1): 45.     CrossRef
  • Improving Non-Invasive Prediction of Thyroid Nodule Malignancy: A Machine Learning-Based Clinical Approach
    Maja Reiner, Hanna Drobińska, Michał Miciak, Michał Kisiel, Szymon Biernat, Krzysztof Kaliszewski
    Cancer Management and Research.2026; Volume 18: 1.     CrossRef
  • An early evaluation of MedSigLIP in thyroid cytology: a comparative frozen-encoder benchmark against ImageNet-pretrained encoders
    Mehmet Poyrazer, Rıdvan Erten
    Frontiers in Endocrinology.2026;[Epub]     CrossRef
  • Deep Learning for the Diagnosis and Treatment of Thyroid Cancer: A Review
    Rili Gao, Shangqing Mai, Song Wang, Wuqiang Hu, Zhangqi Chang, Guozhi Wu, Haixia Guan
    Endocrine Practice.2025; 31(12): 1608.     CrossRef
  • Artificial Intelligence for Thyroid Ultrasound: Clinical Performance, Pitfalls, and Practice Integration
    Junseok Kang, Jihyun Ahn, Jeong Hun Hah
    Clinical Ultrasound.2025; 10(2): 59.     CrossRef
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Thyroid
In Vitro Investigation of HIF-1α as a Therapeutic Target for Thyroid-Associated Ophthalmopathy
Jeongmin Lee, Jinsoo Lee, Hansang Baek, Dong-Jun Lim, Seong-Beom Lee, Jung-Min Lee, Sang-Ah Jang, Moo Il Kang, Suk-Woo Yang, Min-Hee Kim
Endocrinol Metab. 2024;39(5):767-776.   Published online October 16, 2024
DOI: https://doi.org/10.3803/EnM.2024.1952
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  • 3 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Thyroid-associated ophthalmopathy (TAO) involves tissue expansion and inflammation, potentially causing a hypoxic microenvironment. Hypoxia-inducible factor (HIF)-1α is crucial in fibrosis and adipogenesis, which are observed in TAO progression. We investigated the effects of hypoxia on orbital fibroblasts (OFs) in TAO, focusing on the role of HIF-1α in TAO progression.
Methods
OFs were isolated from TAO and non-TAO patients (as controls). In addition to HIF-1α, adipogenic differentiation markers including peroxisome proliferator-activated receptor γ (PPARγ) and CCAAT/enhancer binding protein (CEBP) were measured by Western blot, and phenotype changes were evaluated by Oil Red O staining under both normoxia and hypoxia. To elucidate the effect of HIF-1α inhibition, protein expression changes after HIF-1α inhibitor treatment were evaluated under normoxia and hypoxia.
Results
TAO OFs exhibited significantly higher HIF-1α expression than non-TAO OFs, and the difference was more distinct under hypoxia than under normoxia. Oil Red O staining showed that adipogenic differentiation of TAO OFs was prominent under hypoxia. Hypoxic conditions increased the expression of adipogenic markers, namely PPARγ and CEBP, as well as HIF-1α in TAO OFs. Interleukin 6 levels also increased in response to hypoxia. The effect of hypoxia on adipogenesis was reduced at the protein level after HIF-1α inhibitor treatment, and this inhibitory effect was sustained even with IGF-1 stimulation in addition to hypoxia.
Conclusion
Hypoxia induces tissue remodeling in TAO by stimulating adipogenesis through HIF-1α activation. These data could provide insights into new treatment strategies and the mechanisms of adipose tissue remodeling in TAO.

Citations

Citations to this article as recorded by  
  • Hypoxia-Inducible Factor 1-α in Autoimmune Diseases—Insights from the Paradigm of Hashimoto’s Thyroiditis: A Narrative Review
    Nika Srb, Andrea Milostić-Srb, Lea Sarić, Dubravka Holik, Matej Šapina, Rajko Fureš, Jasminka Talapko, Ivana Škrlec, Darko Katalinić, Borna Kovačić
    Medical Sciences.2026; 14(1): 61.     CrossRef
  • Integrative transcriptomic profiling and machine learning reveal hypoxia-associated molecular signatures for precision diagnosis in thyroid eye disease
    Weijin Qian, Tianyi Zhu, Jin Liu, Yining Wei, Li Yang, Lianfei Fang, Jing Sun, Yinwei Li, Sijie Fang, Huifang Zhou
    Human Genomics.2025;[Epub]     CrossRef
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Thyroid
Thyroid Cancer Screening
Cost-Utility Analysis of Early Detection with Ultrasonography of Differentiated Thyroid Cancer: A Retrospective Study on a Korean Population
Han-Sang Baek, Jeonghoon Ha, Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, Sungju Kim, Dong-Jun Lim, Chul-Min Kim
Endocrinol Metab. 2024;39(2):310-323.   Published online April 9, 2024
DOI: https://doi.org/10.3803/EnM.2023.1870
  • 7,179 View
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  • 1 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
There is debate about ultrasonography screening for thyroid cancer and its cost-effectiveness. This study aimed to evaluate the cost-effectiveness of early screening (ES) versus symptomatic detection (SD) for differentiated thyroid cancer (DTC) in Korea.
Methods
A Markov decision analysis model was constructed to compare the cost-effectiveness of ES and SD. The model considered direct medical costs, health outcomes, and different diagnostic and treatment pathways. Input data were derived from literature and Korean population studies. Incremental cost-effectiveness ratio (ICER) was calculated. Willingness-to-pay (WTP) threshold was set at USD 100,000 or 20,000 per quality-adjusted life year (QALY) gained. Sensitivity analyses were conducted to address uncertainties of the model’s variables.
Results
In a base case scenario with 50 years of follow-up, ES was found to be cost-effective compared to SD, with an ICER of $2,852 per QALY. With WTP set at $100,000, in the case with follow-up less than 10 years, the SD was cost-effective. Sensitivity analysis showed that variables such as lobectomy probability, age, mortality, and utility scores significantly influenced the ICER. Despite variations in costs and other factors, all ICER values remained below the WTP threshold.
Conclusion
Findings of this study indicate that ES is a cost-effective strategy for DTC screening in the Korean medical system. Early detection and subsequent lobectomy contribute to the cost-effectiveness of ES, while SD at an advanced stage makes ES more cost-effective. Expected follow-up duration should be considered to determine an optimal strategy for DTC screening.

Citations

Citations to this article as recorded by  
  • Conventional and Emerging Diagnostic Approaches for Differentiated Thyroid Carcinoma
    Kathelina Kristollari, Abraham Abbey Paul, Sagi Angel, Robert S. Marks
    Chemosensors.2024; 12(11): 229.     CrossRef
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Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
Long-Term Cumulative Exposure to High γ-Glutamyl Transferase Levels and the Risk of Cardiovascular Disease: A Nationwide Population-Based Cohort Study
Han-Sang Baek, Bongseong Kim, Seung-Hwan Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Sang-Ah Chang, Kyungdo Han, Jae-Seung Yun
Endocrinol Metab. 2023;38(6):770-781.   Published online November 6, 2023
DOI: https://doi.org/10.3803/EnM.2023.1726
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  • 7 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Elevated γ-glutamyl transferase (γ-GTP) levels are associated with metabolic syndrome. We investigated the association of cumulative exposure to high γ-GTP with the risk of cardiovascular disease (CVD) in a large-scale population.
Methods
Using nationally representative data from the Korean National Health Insurance system, 1,640,127 people with 4 years of consecutive γ-GTP measurements from 2009 to 2012 were included and followed up until the end of 2019. For each year of the study period, participants were grouped by the number of exposures to the highest γ-GTP quartile (0–4), and the sum of quartiles (0–12) was defined as cumulative γ-GTP exposure. The hazard ratio for CVD was evaluated using the Cox proportional hazards model.
Results
During the 6.4 years of follow-up, there were 15,980 cases (0.97%) of myocardial infarction (MI), 14,563 (0.89%) of stroke, 29,717 (1.81%) of CVD, and 25,916 (1.58%) of death. Persistent exposure to high γ-GTP levels was associated with higher risks of MI, stroke, CVD, and death than those without such exposure. The risks of MI, stroke, CVD, and mortality increased in a dose-dependent manner according to total cumulative γ-GTP (all P for trend <0.0001). Subjects younger than 65 years, with a body mass index <25 kg/m2, and without hypertension or fatty liver showed a stronger relationship between cumulative γ-GTP and the incidence of MI, CVD, and death.
Conclusion
Cumulative γ-GTP elevation is associated with CVD. γ-GTP could be more widely used as an early marker of CVD risk, especially in individuals without traditional CVD risk factors.

Citations

Citations to this article as recorded by  
  • Latent class analysis of association between occupational hazard factors and gamma-glutamyltransferase in automobile manufacturing workers: a cross-sectional study
    Huixia Ji, Dandan Liu, Ye Chen
    Frontiers in Public Health.2026;[Epub]     CrossRef
  • Association of Serum Gamma-Glutamyltransferase with In-hospital Heart Failure in Patients with ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
    An-Cheng Hou, Jian-Tong Hou, Wei-Ning Zhou, Yan-Jin Wei, Zhi-Hong Ou, Cun-Fei Liu
    Reviews in Cardiovascular Medicine.2025;[Epub]     CrossRef
  • The J-shaped relationship between the gamma-glutamyltransferase to high-density lipoprotein cholesterol ratio and mortality risk in U.S. adults
    Shujuan Qiu, Chunlei Li, Zhentao Guo
    Preventive Medicine Reports.2025; 52: 102958.     CrossRef
  • Association between the levels of gamma-glutamyl transpeptidase and the risk of stroke: systematic review and meta-analysis
    Gustavo Adolfo Vásquez-Tirado, Stefany M. Nieto-Rivera, Claudia Vanessa Quispe-Castañeda, Edinson Dante Meregildo-Rodríguez, Leslie Jacqueline Liñán-Díaz, Wilson Marcial Guzmán-Aguilar
    Arquivos de Neuro-Psiquiatria.2025; 83(07): 001.     CrossRef
  • Serum gamma-glutamyl transferase level is associated with the risk of pancreatic cystic neoplasms: A nationwide retrospective cohort study
    Min Woo Lee, Jin Myung Park, In Rae Cho, Kwang Hyun Chung, Bong Seong Kim, Jin Ho Choi, Woo Hyun Paik, Ji Kon Ryu, Kyungdo Han, Sang Hyub Lee
    World Journal of Gastroenterology.2025;[Epub]     CrossRef
  • Interplay of serum biomarkers bilirubin and γ-glutamyltranspeptidase in predicting cardiovascular complications in type-2 diabetes mellitus
    Ebtesam Abdullah Al-Suhaimi, Abdullah Ahmed Al-Rubaish
    World Journal of Diabetes.2024; 15(6): 1074.     CrossRef
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Thyroid
Exploring the Association between Thyroid Function and Frailty: Insights from Representative Korean Data
Youn-Ju Lee, Min-Hee Kim, Dong-Jun Lim, Jung-Min Lee, Sang Ah Chang, Jeongmin Lee
Endocrinol Metab. 2023;38(6):729-738.   Published online November 2, 2023
DOI: https://doi.org/10.3803/EnM.2023.1769
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AbstractAbstract PDFPubReader   ePub   
Background
This study investigates the association between thyroid function and frailty in the old patients using representative data.
Methods
The study was conducted using data from the Korea National Health and Nutrition Examination Survey conducted from 2013 to 2015. The study population included 2,416 participants aged 50 years and older with available thyroid function test data. Frailty assessment was performed using the Fried frailty phenotype. The prevalence of frailty was analyzed across different thyroid diseases and thyroid function parameters.
Results
The significant association between thyroid dysfunction and frailty was observed in overt hyperthyroidism and subclinical hyperthyroidism. After adjusting for various factors, the association between thyroid dysfunction and frailty remained significant. On the other hand, overt hypothyroidism did not show a significant association with frailty in the adjusted analysis. For individuals with overt hyperthyroidism and subclinical hyperthyroidism, higher levels of free thyroxine (FT4) were significantly associated with an increased risk of frailty (aOR >999; 95% CI, >999 to 999). Among individuals with overt hypothyroidism, lower level of FT4 levels and high thyrotropin (TSH) levels showed a significant association with frailty risk (FT4: aOR, <0.01; TSH: aOR, 999). In participants with subclinical hypothyroidism, there were no significant associations between parameters for thyroid and frailty risk.
Conclusion
These findings suggest that thyroid dysfunction, particularly overt hyperthyroidism and subclinical hyperthyroidism, may be associated with an increased risk of frailty in the old patients.

Citations

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  • Association of iodized salt intake with the risk of physical frailty in patients with type 2 diabetes
    Jiang Li, Jie Li, Ying Sun, Yanqi Fu, Wenqi Shen, Lingli Cai, Fei Xu, Ling Gao, Ningjian Wang, Bin Wang, Yingli Lu
    The Journal of nutrition, health and aging.2025; 29(6): 100543.     CrossRef
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    Xiaotian Shi, Huayu Yang, Shan Wang, Yifan Yang, Yuanyuan Li, Guoze Dou, Qing Ma
    European Geriatric Medicine.2025; 16(5): 1861.     CrossRef
  • Associations between thyroid function, thyroid hormone sensitivity indices, and frailty: Insights from a large cross-sectional study
    Yusheng Zhang, Daowen Zhang, Chenwen Yuan, Yiming Wang, Hao Zhu, Yu Duan
    Experimental Gerontology.2025; 208: 112822.     CrossRef
  • Subclinical hyperthyroidism
    Alasdair Cooper, Prakash Abraham
    Current Opinion in Endocrinology, Diabetes & Obesity.2025; 32(5): 175.     CrossRef
  • Endocrine Adaptations to Prolonged Fasting: From Physiology, Clinical Uncertainties, Translational Challenges to Healthspan Implications
    Rok Herman, Jure Trsan, Luka Lipar, Mojca Jensterle, Andrej Janez
    Nutrients.2025; 17(24): 3949.     CrossRef
  • Associations of thyroid feedback quantile-based index with diabetes in euthyroid adults in the United States and China
    Heng Wan, Genfeng Yu, Yajun He, Siyang Liu, Xingying Chen, Yuqi Jiang, Hualin Duan, Xu Lin, Lan Liu, Jie Shen
    Annals of Medicine.2024;[Epub]     CrossRef
  • Comorbid Hypothyroidism and Low-Alanine Aminotransferase-Associated Sarcopenia Associated with Shortened Survival: A Retrospective Study of 16,827 Patients over a 21-Year Period
    Omer Segal, Rabia Khoury, Adva Vaisman, Gad Segal
    Journal of Clinical Medicine.2024; 13(19): 5838.     CrossRef
  • A Neglected Point: Frailty in Older Adults with Differentiated Thyroid Cancer
    Meric Coskun, Esra Cataltepe, Hacer Dogan Varan, Eda Ceker, Yasemin Bektas, Yasemin Kuscu, Mehmet Muhittin Yalcin, Mujde Akturk, Fusun Balos Toruner, Mehmet Ayhan Karakoc, Alev Eroglu Altinova
    Endocrinology and Metabolism.2024; 39(6): 899.     CrossRef
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Thyroid
The Early Changes in Thyroid-Stimulating Immunoglobulin Bioassay over Anti-Thyroid Drug Treatment Could Predict Prognosis of Graves’ Disease
Jin Yu, Han-Sang Baek, Chaiho Jeong, Kwanhoon Jo, Jeongmin Lee, Jeonghoon Ha, Min Hee Kim, Jungmin Lee, Dong-Jun Lim
Endocrinol Metab. 2023;38(3):338-346.   Published online June 9, 2023
DOI: https://doi.org/10.3803/EnM.2023.1664
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  • 6 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To determine whether baseline thyroid-stimulating immunoglobulin (TSI) bioassay or its early response upon treatment with an anti-thyroid drug (ATD) can predict prognosis of Graves’ disease (GD) in real-world practice.
Methods
This retrospective study enrolled GD patients who had previous ATD treatment with TSI bioassay checked at baseline and at follow-up from April 2010 to November 2019 in one referral hospital. The study population were divided into two groups: patients who experienced relapse or continued ATD (relapse/persistence), and patients who experienced no relapse after ATD discontinuation (remission). The slope and area under the curve at 1st year (AUC1yr) of thyroid-stimulating hormone receptor antibodies including TSI bioassay and thyrotropin-binding inhibitory immunoglobulin (TBII) were calculated as differences between baseline and second values divided by time duration (year).
Results
Among enrolled 156 study subjects, 74 (47.4%) had relapse/persistence. Baseline TSI bioassay values did not show significant differences between the two groups. However, the relapse/persistence group showed less decremental TSI bioassay in response to ATD than the remission group (–84.7 [TSI slope, –198.2 to 8.2] vs. –120.1 [TSI slope, –204.4 to –45.9], P=0.026), whereas the TBII slope was not significantly different between the two groups. The relapse/persistence group showed higher AUC1yr of TSI bioassay and TBII in the 1st year during ATD treatment than the remission group (AUC1yr for TSI bioassay, P=0.0125; AUC1yr for TBII, P=0.001).
Conclusion
Early changes in TSI bioassay can better predict prognosis of GD than TBII. Measurement of TSI bioassay at beginning and follow-up could help predict GD prognosis.

Citations

Citations to this article as recorded by  
  • Predictors of Treatment Outcomes in Pediatric Graves’ Disease
    Do Young Shin, Eungu Kang, Hyo-Kyoung Nam, Kee-Hyoung Lee, Young-Jun Rhie
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • A Predictive Model for Graves’ Disease Recurrence After Antithyroid Drug Therapy: A Retrospective Multicenter Cohort Study
    Omar El Kawkgi, David Toro-Tobon, Freddy J.K. Toloza, Sebastian Vallejo, Cristian Soto Jacome, Ivan N. Ayala, Bryan A. Vallejo, Camila Wenczenovicz, Olivia Tzeng, Horace J. Spencer, Jeff D. Thostenson, Dingfeng Li, Jacob Kohlenberg, Eddy Lincango, Sneha M
    Endocrine Practice.2025; 31(4): 455.     CrossRef
  • Microvascular Ultrasonography Vascularity Index as a Rapid and Simplified Assessment Tool for Differentiating Graves’ Disease from Destructive Thyroiditis and Managing Thyrotoxicosis
    Han-Sang Baek, Chaiho Jeong, Jeonghoon Ha, Dong-Jun Lim
    Endocrinology and Metabolism.2025; 40(3): 394.     CrossRef
  • High TRAb Titer at Diagnosis Predicts Persistent Positivity and Relapse in Graves’ Disease after Prolonged Antithyroid Therapy
    Zimiao Chen, Jinglu Xu, Wenrui Kang, Yang Zhang, Rujun Chen, Xiaohua Gong
    Endocrinology and Metabolism.2025; 40(6): 950.     CrossRef
  • Enhanced predictive validity of integrative models for refractory hyperthyroidism considering baseline and early therapy characteristics: a prospective cohort study
    Xinpan Wang, Tiantian Li, Yue Li, Qiuyi Wang, Yun Cai, Zhixiao Wang, Yun Shi, Tao Yang, Xuqin Zheng
    Journal of Translational Medicine.2024;[Epub]     CrossRef
  • Long-term Effect of Thyrotropin-binding Inhibitor Immunoglobulin on Atrial Fibrillation in Euthyroid Patients
    Jung-Chi Hsu, Kang-Chih Fan, Ting-Chuan Wang, Shu-Lin Chuang, Ying-Ting Chao, Ting-Tse Lin, Kuan-Chih Huang, Lian-Yu Lin, Lung-Chun Lin
    Endocrine Practice.2024; 30(6): 537.     CrossRef
  • Dynamic Risk Model for the Medical Treatment of Graves’ Hyperthyroidism according to Treatment Duration
    Meihua Jin, Chae A Kim, Min Ji Jeon, Won Bae Kim, Tae Yong Kim, Won Gu Kim
    Endocrinology and Metabolism.2024; 39(4): 579.     CrossRef
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Diabetes, Obesity and Metabolism
Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes (Endocrinol Metab 2022;37:641-51, Han-sang Baek et al.)
Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim
Endocrinol Metab. 2022;37(6):945-946.   Published online December 2, 2022
DOI: https://doi.org/10.3803/EnM.2022.602
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PDFPubReader   ePub   

Citations

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  • Young patients with type 2 diabetes have high relative risks for complications in a country with middle-high sociodemographic index, similarly to those countries with high index
    Gergő A. Molnár, Zoltán Kiss, István Wittmann
    Frontiers in Endocrinology.2025;[Epub]     CrossRef
  • Differences in cardiovascular disease incidence according to changes in obesity status in young diabetic patients
    Do Kyeong Song, Yeon-Ah Sung, Young Sun Hong, Min-ho Kim, Hyejin Lee
    Cardiovascular Diabetology – Endocrinology Reports.2025;[Epub]     CrossRef
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Original Articles
Diabetes, Obesity and Metabolism
Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes
Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim
Endocrinol Metab. 2022;37(4):641-651.   Published online August 29, 2022
DOI: https://doi.org/10.3803/EnM.2022.1501
  • 12,802 View
  • 246 Download
  • 17 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Background
The prevalence of young-onset diabetes (YOD) has been increasing worldwide. As the incidence of YOD increases, it is necessary to determine the characteristics of YOD and the factors that influence its development and associated complications.
Methods
In this retrospective study, we recruited patients who were diagnosed with type 2 diabetes mellitus between June 2001 and December 2021 at a tertiary hospital. The study population was categorized according to age: YOD (age <40 years), middle-age-onset diabetes (MOD, 40≤ age <65 years), and late-onset diabetes (LOD, age ≥65 years). We examined trends in glycemic control by analyzing fasting glucose levels during the first year in each age group. A Cox proportional-hazards model was used to determine the relative risk of developing complications according to glycemic control trends.
Results
The fasting glucose level at the time of diagnosis was highest in the YOD group (YOD 149±65 mg/dL; MOD 143±54 mg/dL; and LOD 140±55 mg/dL; p=0.009). In the YOD group, glucose levels decreased at 3 months, but increased by 12 months. YOD patients and those with poor glycemic control in the first year were at a higher risk of developing complications, whereas the risk in patients with LOD was not statistically significant.
Conclusion
YOD patients had higher glucose levels at diagnosis, and their glycemic control was poorly maintained. As poor glycemic control can influence the development of complications, especially in young patients, intensive treatment is necessary for patients with YOD.

Citations

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  • Association of Age at Type 2 Diabetes Onset With Diabetes Progression
    Seyedeh Forough Sajjadi, Julian W. Sacre, Agus Salim, Brian Oldenburg, Panniyammakal Jeemon, Kavumpurathu R. Thankappan, Sathish Thirunavukkarasu, Dianna J. Magliano, Jonathan E. Shaw
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    Francesco Zaccardi, Vanita R. Aroda, Ecenur Guder Arslan, Lars Bardtrum, Jonathan Goldney, Erik Ising, Prachi Priyadarshini, Tommy Slater, Melanie J. Davies
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    Jaejun Lee, Dong Yeup Lee, Jae Hyeop Jung, Eunkyoung Bae, Jeong A. Yu, Hyun Yang
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  • Association between body mass index and survival after hematopoietic stem cell transplantation
    Han-Sang Baek, Jong Hyuk Lee, Joonyub Lee, Seung-Hwan Lee, Gi June Min, Sung-Soo Park, Silvia Park, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Hee-Je Kim, Chang-Ki Min, Seok-Goo Cho, Jong Wook Lee, Jae-Ho Yoon
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    Seohyun Kim, Gyuri Kim, So Hyun Cho, Rosa Oh, Ji Yoon Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim
    Diabetes & Metabolism.2024; 50(1): 101505.     CrossRef
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    Da Hea Seo, Mina Kim, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongbin Hong, So Hun Kim
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  • Impact of diabetes distress on glycemic control and diabetic complications in type 2 diabetes mellitus
    Hye-Sun Park, Yongin Cho, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, Young Ju Suh, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Kwan Woo Lee, So Hun Kim
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    Myrsini Strati, Melpomeni Moustaki, Theodora Psaltopoulou, Andromachi Vryonidou, Stavroula A. Paschou
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  • The Effect of Glycemic Control on Cardiovascular Disease Progression in Adults With Early-Onset Type 2 Diabetes: A Longitudinal Cohort Analysis
    Amna Gilani, Khalid Umar, Fatima Gilani, Muhammad Ahmad, Mahnoor S Abbasi, Muhammad Yaseen, Muhammad Zeeshan, Naqeeb Ullah, Aiman Waseem, Fatima Batool, Sundas Safdar
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    Fahimeh Soheilipour, Naghmeh Abbasi Kasbi, Mahshid Imankhan, Delaram Eskandari
    International Journal of Endocrinology and Metabolism.2023;[Epub]     CrossRef
  • Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes (Endocrinol Metab 2022;37:641-51, Han-sang Baek et al.)
    Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim
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    Anju Virmani, Stuart J. Brink, Angela Middlehurst, Fauzia Mohsin, Franco Giraudo, Archana Sarda, Sana Ajmal, Julia E. von Oettingen, Kuben Pillay, Supawadee Likitmaskul, Luis Eduardo Calliari, Maria E. Craig
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Thyroid
Quality of Life of Survivors of Thyroid Cancer Is Not Inferior to That in Subjects without Cancer: Long-Term after Over 5 Years
Jeongmin Lee, Youn-Ju Lee, Dong-Jun Lim, Jung-Min Lee, Sang-Ah Chang, Min-Hee Kim
Endocrinol Metab. 2022;37(4):664-673.   Published online August 29, 2022
DOI: https://doi.org/10.3803/EnM.2022.1499
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Patients with thyroid cancer undergo less extensive surgery and additional therapies compared to those with other cancers. We aimed to compare the quality of life (QoL) between patients with thyroid cancer and healthy subjects using representative data from Korea. Differences in QoL of thyroid cancer survivors according to the duration after cancer diagnosis was also evaluated.
Methods
This population-based cohort study included 50,278 subjects who participated in the Korea National Health and Nutrition Examination Survey between 2007 and 2017. QoL was compared between patients with thyroid cancer and healthy subjects using self-reported data from the EuroQoL (EQ)-5 dimension (5D) and EQ-visual analog scale (VAS). Propensity score matching was used to match thyroid cancer survivors to healthy subjects (1:5 matching).
Results
Linear regression with univariate analysis showed that the presence of thyroid cancer was positively correlated with better EQ-5D index scores (β-coefficient=0.010, p=0.046). After adjusting for multiple covariables, statistical significance was maintained. EQ-VAS fails to demonstrate any significant correlation. Among the EQ-5D categories, patients with thyroid cancer showed better self-care than healthy subjects. Thyroid cancer duration did not correlate with the EQ-5D index score. In subgroup analyses, compared to patients with thyroid cancer duration of <5 years, no significant difference was observed in the correlation between the EQ-5D index score and survival duration in those with thyroid cancer duration of 5 to 9 years and ≥10 years.
Conclusion
Using a large-scale nationwide population-based database, our study demonstrated better QoL, especially in terms of self-care, among thyroid cancer survivors than among healthy subjects without cancer.

Citations

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  • Patient preferences in papillary thyroid microcarcinoma management are driven by aversion toward complications rather than treatment pathway
    Rebecca Kowalski, Kendyl Carlisle, Aprill N. Park, Salome Ricci, Reuben Don, Carrie Cunningham, Julia F. Slejko, C. Daniel Mullins, Yinin Hu
    Surgery.2026; 189: 109694.     CrossRef
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    Nadjib Kaouache, Abdelhak Lakehal, Nassim Nouri
    AACE Endocrinology and Diabetes.2026; 13(2): 139.     CrossRef
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    Gerasimos P. Sykiotis, Athina Mageiropoulou, Akram Al-Ibraheem, Monica Pinto, Ioannis Iakovou, Arild Andre Østhus, Eva Gamper, Eva Hammerlid, Laura Deborah Locati, Ricardo Ribeiro Gama, Giuseppe Fanetti, Naomi Kiyota, Juan Ignacio Arraras, Johanna Inheste
    Thyroid®.2026;[Epub]     CrossRef
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    Christine J. O’Neill, Christopher W. Rowe, Harriet Morris-Baguley, Melissa A. Carlson, Sarah Leask, Tara Clinton-McHarg, Elizabeth Holliday, Elizabeth A. Fradgley, Christine L. Paul
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    Kendyl Carlisle, Rebecca Kowalski, Aprill N. Park, Salome Ricci, Kai Sun, Carrie Cunningham, Julia F. Slejko, C. Daniel Mullins, Yinin Hu
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    Byung Hun Kim, Soo Rack Ryu, Jin Won Lee, Chang Myeon Song, Yong Bae Ji, Seok Hyun Cho, Seung Hwan Lee, Kyung Tae
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    Jie Liu
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    Simone de Leo
    Clinical Thyroidology®.2024; 36(8): 294.     CrossRef
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    Jie Liu
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    Parker Haymart, Nina Jackson Levin, Megan R. Haymart
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Thyroid
Usefulness of Real-Time Quantitative Microvascular Ultrasonography for Differentiation of Graves’ Disease from Destructive Thyroiditis in Thyrotoxic Patients
Han-Sang Baek, Ji-Yeon Park, Chai-Ho Jeong, Jeonghoon Ha, Moo Il Kang, Dong-Jun Lim
Endocrinol Metab. 2022;37(2):323-332.   Published online April 13, 2022
DOI: https://doi.org/10.3803/EnM.2022.1413
  • 7,815 View
  • 191 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Microvascular ultrasonography (MVUS) is a third-generation Doppler technique that was developed to increase sensitivity compared to conventional Doppler. The purpose of this study was to compare MVUS with conventional color Doppler (CD) and power Doppler (PD) imaging to distinguish Graves’ disease (GD) from destructive thyroiditis (DT).
Methods
This prospective study included 101 subjects (46 GDs, 47 DTs, and eight normal controls) from October 2020 to November 2021. All ultrasonography examinations were performed using microvascular flow technology (MV-Flow). The CD, PD, and MVUS images were semi-quantitatively graded according to blood flow patterns. On the MVUS images, vascularity indices (VIs), which were the ratio (%) of color pixels in the total grayscale pixels in a defined region of interest, were obtained automatically. Receiver operating characteristic curve analysis was performed to verify the diagnostic performance of MVUS. The interclass correlation coefficient and Cohen’s kappa analysis were used to analyze the reliability of MVUS (ClinicalTrials.gov:NCT04879173).
Results
The area under the curve (AUC) for CD, PD, MVUS, and MVUS-VI was 0.822, 0.844, 0.808, and 0.852 respectively. The optimal cutoff value of the MVUS-VI was 24.95% for distinguishing GD and DT with 87% sensitivity and 80.9% specificity. We found a significant positive correlation of MVUS-VI with thyrotropin receptor antibody (r=0.554) and with thyroid stimulating immunoglobulin bioassay (r=0.841). MVUS showed high intra- and inter-observer reliability from various statistical method.
Conclusion
In a real time and quantitative manner, MVUS-VI could be helpful to differentiate GD from thyroiditis in thyrotoxic patients, with less inter-observer variability.

Citations

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  • Microvascular Ultrasonography Vascularity Index as a Rapid and Simplified Assessment Tool for Differentiating Graves’ Disease from Destructive Thyroiditis and Managing Thyrotoxicosis
    Han-Sang Baek, Chaiho Jeong, Jeonghoon Ha, Dong-Jun Lim
    Endocrinology and Metabolism.2025; 40(3): 394.     CrossRef
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    Jin Wang, Ke Wan, Xin Chang, Rui-Feng Mao
    World Journal of Diabetes.2024; 15(3): 348.     CrossRef
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    Han-Sang Baek, Jinyoung Kim, Chaiho Jeong, Jeongmin Lee, Jeonghoon Ha, Kwanhoon Jo, Min-Hee Kim, Tae Seo Sohn, Ihn Suk Lee, Jong Min Lee, Dong-Jun Lim
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    Early Human Development.2024; 199: 106149.     CrossRef
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Close layer
Thyroid
Lobeglitazone, A Peroxisome Proliferator-Activated Receptor-Gamma Agonist, Inhibits Papillary Thyroid Cancer Cell Migration and Invasion by Suppressing p38 MAPK Signaling Pathway
Jun-Qing Jin, Jeong-Sun Han, Jeonghoon Ha, Han-Sang Baek, Dong-Jun Lim
Endocrinol Metab. 2021;36(5):1095-1110.   Published online October 14, 2021
DOI: https://doi.org/10.3803/EnM.2021.1155
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AbstractAbstract PDFPubReader   ePub   
Background
Peroxisome proliferator-activated receptor-gamma (PPAR-γ) ligands have been widely shown to correlate with epithelial-mesenchymal transition (EMT) and cancer progression. Lobeglitazone (LGZ) is a novel ligand of PPAR-γ; and its role in EMT and metastasis in papillary thyroid carcinoma (PTC) is poorly understood. We aimed to investigate the role of LGZ in metastatic behavior of PTC cells.
Methods
Half maximal inhibitory concentration (IC50) values of LGZ in BRAF-mutated PTC cell lines (BCPAP and K1) were determined using MTT assay. Rosiglitazone (RGZ), the PPAR-γ ligand was used as a positive control. The protein expression of PPAR-γ, cell-surface proteins (E-cadherin, N-cadherin), cytoskeletal protein (Vimentin), transcription factor (Snail), p38 mitogenactivated protein kinase (MAPK), extracellular signal-regulated kinase (ERK) 1/2 pathway, and matrix metalloproteinase (MMP)-2 expression were measured using Western blotting. Changes in E-cadherin expression were also determined using immunocytochemistry. Cell migration and invasion were analyzed using wound healing and Matrigel invasion assays.
Results
Treatment with LGZ or RGZ significantly inhibited transforming growth factor-beta1 (TGF-β1)-induced EMT-associated processes such as fibroblast-like morphological changes, EMT-related protein expression, and increased cell migration and invasion in BCPAP and K1 cells. LGZ restored TGF-β1-induced loss of E-cadherin, as observed using immunocytochemistry. Furthermore, LGZ and RGZ suppressed TGF-β1-induced MMP-2 expression and phosphorylation of p38 MAPK, but not ERK1/2. Although there was no change in PPAR-γ expression after treatment with LGZ or RGZ, the effect of downstream processes mediated by LGZ was hampered by GW9662, a PPAR-γ antagonist.
Conclusion
LGZ inhibits TGF-β1-induced EMT, migration, and invasion through the p38 MAPK signaling pathway in a PPAR-γ-dependent manner in PTC cells.

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    Ojasvi Gupta, Tathagata Pradhan, Gita Chawla
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Close layer
Hypothalamus and Pituitary Gland
Heart Rate Variability in Postoperative Patients with Nonfunctioning Pituitary Adenoma
Jeonghoon Ha, Hansang Baek, Chaiho Jeong, Minsoo Yeo, Seung-Hwan Lee, Jae Hyoung Cho, Ki-Hyun Baek, Moo Il Kang, Dong-Jun Lim
Endocrinol Metab. 2021;36(3):678-687.   Published online June 10, 2021
DOI: https://doi.org/10.3803/EnM.2021.978
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Decreased heart rate variability (HRV) has been reported to be associated with cardiac autonomic dysfunction. Hypopituitarism in nonfunctioning pituitary adenoma (NFPA) is often linked to increased cardiovascular mortality. We therefore hypothesized that postoperative NFPA patients with hormone deficiency have an elevated risk of HRV alterations indicating cardiac autonomic dysfunction.
Methods
A total of 22 patients with NFPA were enrolled in the study. Between 3 and 6 months after surgery, a combined pituitary function test (CPFT) was performed, and HRV was measured. The period of sleep before the CPFT was deemed the most stable period, and the hypoglycemic period that occurred during the CPFT was defined as the most unstable period. Changes in HRV parameters in stable and unstable periods were observed and compared depending on the status of hormone deficiencies.
Results
In patients with adrenocorticotropic hormone (ACTH) deficiency with other pituitary hormone deficiencies, the low frequency to high frequency ratio, which represents overall autonomic function and is increased in the disease state, was higher (P=0.005). Additionally, the standard deviation of the normal-to-normal interval, which decreases in the autonomic dysfunction state, was lower (P=0.030) during the hypoglycemic period. In panhypopituitarism, the low frequency to high frequency ratio during the hypoglycemic period was increased (P=0.007).
Conclusion
HRV analysis during CPFT enables estimation of cardiac autonomic dysfunction in patients with NFPA who develop ACTH deficiency with other pituitary hormone deficiencies or panhypopituitarism after surgery. These patients may require a preemptive assessment of cardiovascular risk.

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    Maria Bernadette Cilona, Filippo D’Amico, Chiara Asperti, Giuseppe Alvise Ramirez, Stefano Turi, Giovanni Benanti, Shai Marc Bohane, Serena Nannipieri, Rosa Labanca, Matteo Gervasini, Federica Russetti, Naomi Viapiana, Martina Lezzi, Giovanni Landoni, Lor
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    Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo
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Close layer
Clinical Study
Association of Hyperparathyroidism and Papillary Thyroid Cancer: A Multicenter Retrospective Study
Chaiho Jeong, Hye In Kwon, Hansang Baek, Hun-Sung Kim, Dong-Jun Lim, Ki-Hyun Baek, Jeonghoon Ha, Moo Il Kang
Endocrinol Metab. 2020;35(4):925-932.   Published online December 10, 2020
DOI: https://doi.org/10.3803/EnM.2020.725
  • 10,117 View
  • 217 Download
  • 17 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Concomitant papillary thyroid cancer (PTC) and hyperparathyroidism (HPT) have been reported in several studies. Our study aimed to investigate the incidence of concomitant PTC in HPT patients upon preoperative diagnosis and present a clinical opinion on detecting thyroid malignancy in case of parathyroidectomy.
Methods
Patients who underwent parathyroidectomy between January 2009 and December 2019 in two medical centers were included. Of the 279 participants 154 were diagnosed as primary hyperparathyroidism (pHPT) and 125 as secondary hyperparathyroidism (sHPT). The incidence of concomitant PTC and its clinical characteristics were compared with 98 patients who underwent thyroidectomy and were diagnosed with classical PTC during the same period.
Results
Concurrent PTC was detected in 14 patients (9.1%) with pHPT and in nine patients (7.2%) with sHPT. Ten (71.4%) and seven (77.8%) PTCs were microcarcinomas in the pHPT and sHPT cases respectively. In the pHPT patients, vitamin D was lower in the pHPT+PTC group (13.0±3.7 ng/mL) than in the pHPT-only group (18.5±10.4 ng/mL; P=0.01). Vitamin D levels were also lower in the sHPT+PTC group (12.3±5.6 ng/mL) than in the sHPT-only group (18.0±10.2 ng/mL; P=0.12). In the concomitant PTC group, lymph node ratio was higher than in the classical PTC group (P=0.00).
Conclusion
A high prevalence of concomitant PTC was seen in patients with pHPT and sHPT. Those concomitant PTCs were mostly microcarcinomas and had more aggressive features, suggesting that efforts should be made to detect concomitant malignancies in the preoperative parathyroidectomy evaluation.

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Close layer
Brief Report
Thyroid
Cholestyramine Use for Rapid Reversion to Euthyroid States in Patients with Thyrotoxicosis
Jeonghoon Ha, Kwanhoon Jo, Borami Kang, Min-Hee Kim, Dong-Jun Lim
Endocrinol Metab. 2016;31(3):476-479.   Published online July 26, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.3.476
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AbstractAbstract PDFPubReader   

Cholestyramine (CS) is an ion exchange resin, which binds to iodothyronines and would lower serum thyroid hormone level. The use of CS added to conventional antithyroid drugs to control thyrotoxicosis has been applied since 1980's, and several studies indicate that using CS in combination with methimazole (MZ) produces a more rapid decline in serum thyroid hormones than with only MZ treatment. Our recent retrospective review of five patients taking high dose MZ and CS, compared to age-, gender-, initial free thyroxine (T4) level-, and MZ dose-matched 12 patients with MZ use only, showed more rapid decline of both free T4 and triiodothyronine levels without more adverse events. CS could be safely applicable short-term adjunctive therapy when first-line antithyroid medications are not enough to adequately control severe thyrotoxicosis or side effects of antithyroid drug would be of great concern.

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    Giona Castagna, Lucrezia Zanchi, Alessandro Rossini, Sara Cassibba, Roberto Trevisan, Silvia Ippolito
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    Fatima Alsalama, Salma Alzaabi, Cynthia Salloum, Marilyne Abi Younes, Feras Bader, Hussam Ghalib, Bassam Atallah
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    Adam Morton
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Close layer
Case Reports
Thyroid
Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy
Yeoree Yang, Seawon Hwang, Minji Kim, Yejee Lim, Min-Hee Kim, Sohee Lee, Dong-Jun Lim, Moo-Il Kang, Bong-Yun Cha
Endocrinol Metab. 2015;30(4):620-625.   Published online December 31, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.4.620
  • 10,204 View
  • 126 Download
  • 17 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   

The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and β-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including β-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies.

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Thyroid
Accelerated Disease Progression after Discontinuation of Sorafenib in a Patient with Metastatic Papillary Thyroid Cancer
Kyung-Jin Yun, Woohyeon Kim, Eun Hee Kim, Min-Hee Kim, Dong-Jun Lim, Moo-Il Kang, Bong-Yun Cha
Endocrinol Metab. 2014;29(3):388-393.   Published online September 25, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.3.388
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AbstractAbstract PDFPubReader   

Distant metastases from papillary thyroid carcinoma (PTC) are rare and are associated with a poor prognosis. Here, we describe a patient with metastatic PTC who was treated with a tyrosine kinase inhibitor (TKI, sorafenib) for several months that was acutely exacerbated by discontinuation. A 43-year-old male was diagnosed with PTC in February 2004 and underwent total thyroidectomy followed by two courses of high-dose radioactive iodine (RAI) therapy. Despite two additional courses of high-dose RAI therapy, lung and muscle metastases were developed. Treatment with sorafenib was begun in September 2010. After 11 months treatment of sorafenib, newly developed metastatic lesions were found in mediastinal lymph nodes, liver, and bones. Considered as treatment failure, the administration of sorafenib was discontinued. Two weeks after sorafenib treatment was stopped, the disease progressed abruptly and caused death of the patient by respiratory failure. In our patient, PTC progressed rapidly after the cessation of sorafenib treatment. Patients with several other types of cancer have also experienced such rapid disease progression, termed "flare-ups." Physicians should be aware that flare-ups may occur in advanced PTC patients following the cessation of TKI therapy.

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