Endocrinology and Metabolism

Original Articles

Diabetes, obesity and metabolism
Safety and Effectiveness of Pravastatin in Korean Patients with Dyslipidemia Based on the Cardiovascular Risk Classification: Pooled Analysis of Four Observational Studies: In-Kyung Jeong, Hyuk-Sang Kwon, Dae Jung Kim, Sin Gon Kim; Endocrinol Metab. 2025;40(4):598-609. Published online April 15, 2025; DOI: https://doi.org/10.3803/EnM.2024.2200

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Background
Despite their efficacy, statin-related adverse events (AEs) may interfere with statin treatment and contribute to negative outcomes in patients with cardiovascular diseases. In this study, we evaluated the safety and effectiveness of pravastatin in Korea.
Methods
Pooled data were collected from four multicenter prospective observational studies conducted in Korea between 2011 and 2020. Finally, 7,334 and 2,022 participants were included in the safety and effectiveness analyses, respectively. Overall safety, particularly muscle-related, incidence of new-onset diabetes mellitus (DM), changes in fasting plasma glucose and hemoglobin A1c level, achievement of target low-density lipoprotein cholesterol (LDL-C) level, and changes in LDL-C level were analyzed.
Results
At week 24, after 20 or 40 mg pravastatin treatment, safety results showed that AEs and adverse drug reactions (ADRs) were 8.7% and 1.3%, respectively, and that muscle-related AEs and ADRs were 0.5% and 0.3%, respectively, with no statistically significant difference in risk factors for statin-associated muscle symptoms. No patients developed DM during the study period. Additionally, at week 24, the achievement rates of target LDL-C levels were 87.9%, 78.4%, 57.8%, and 11.6% in low-, moderate-, high-, and very high-risk groups, respectively.
Conclusion
This study found that 20 or 40 mg pravastatin had minimal side effects and was safe for use in real-world clinical settings in Korea. Specifically, these doses effectively achieved the target LDL-C levels in patients with dyslipidemia in low-, moderate-, and high-risk groups for atherosclerotic cardiovascular disease (ASCVD). These results demonstrate that pravastatin can be safely administered continuously to patients with low-, moderate-, and high-risk ASCVD in a real-world clinical setting.

Citations

Citations to this article as recorded by

Head-to-head comparison of visceral adiposity indices (A Body Shape Index and Visceral Adiposity Index) with traditional anthropometrics: a community-based strategy for cardiovascular risk prediction in urban China
Guoliang Ma, Wenyan Wang, Lin Zhu, Wenting Li, Zhuanzhuan Fan, Weiyi Zhong, Wenjing Zang, Xin Hong, Kun Li
BMJ Open.2025; 15(12): e102918. CrossRef

Diabetes, obesity and metabolism
Discrepancies in Dapagliflozin Response in Terms of Glycemic Control and Body Weight Reduction: Ji Eun Jun, Kyoung-Ah Kim, Nan-Hee Kim, Kwan-Woo Lee, In-Kyung Jeong, on Behalf of the BEYOND Investigators; Endocrinol Metab. 2025;40(2):278-288. Published online March 19, 2025; DOI: https://doi.org/10.3803/EnM.2024.2142

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Background
Dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, reduces hyperglycemia and obesity by inhibiting renal glucose reabsorption. This post hoc study evaluated clinical factors influencing patient response to dapagliflozin.
Methods
The analysis focused on patients treated with dapagliflozin (10 mg/day for 52 weeks) within the randomized, double-blind, parallel-group BEYOND trial. Adequate glycemic control (GC) was defined as a reduction in glycated hemoglobin (HbA1c) of ≥ 1.0% or the achievement of an HbA1c level <7.0% at week 52. Significant weight loss (WL) referred to a reduction in body weight of ≥3.0% at week 52. Participants were classified into four groups based on their GC and WL responses: GC+/WL+, GC+/WL−, GC−/WL+, and GC−/WL−.
Results
Among dapagliflozin recipients (n=56), at 52 weeks, HbA1c had decreased by 1.0%±0.8% from baseline, while body weight had declined by 2.4±3.1 kg. Overall, 69.6% of participants achieved GC+, and 57.1% achieved WL+. Male sex and shorter diabetes duration were significantly associated with achieving GC+. Conversely, higher estimated glomerular filtration rate was significantly linked to WL+. The only factor significantly associated with both GC+ and WL+ was shorter diabetes duration (odds ratio, 0.81; 95% confidence interval, 0.68 to 0.97; P=0.023). The GC+ and WL+ groups exhibited favorable responses beginning soon after dapagliflozin therapy was initiated. Furthermore, HbA1c decline was more strongly associated with reduction in visceral fat than with WL.
Conclusion
A short duration of diabetes and early response to treatment appear to represent key factors in maximizing the benefits of dapagliflozin for blood glucose and weight management.

Citations

Citations to this article as recorded by

Sodium‐glucose cotransporter 2 inhibitor ameliorates thiazolidinedione‐induced fluid retention through vascular leakage reduction in white adipose tissue
Ji Yoon Kim, Hye‐Min Jang, Hye‐Jin Lee, Ah Hyeon Lee, Dong‐Hoon Kim, Sin Gon Kim, Nam Hoon Kim
Diabetes, Obesity and Metabolism.2026; 28(3): 1764. CrossRef
A Pre‐Post Assessment of Blood Glucose Control Following Pharmacist‐Led Professional Continuous Glucose Monitoring in Rhode Island Primary Care Practices
Kelley Doherty Sanzen, Natalya S. Salganik, Susanne M. Campbell, Carolyn A. Karner, Pano M. Yeracaris, Stephen J. Kogut
JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.2026;[Epub] CrossRef
Identification of IL18/IL18R1 signaling as a predictive biomarker of SGLT2 inhibitor efficacy in type 2 diabetes
I-Jou Teng, Chien-Hsing Lee, Ying-Chen Chen, Sheng-Chiang Su, Chieh-Hua Lu, Peng-Fei Li, Chia-Luen Huang, Li-Ju Ho, Ming-Hsun Lin, Hsin-Ya Liu, Feng-Chih Kuo
iScience.2025; 28(10): 113594. CrossRef

Diabetes, obesity and metabolism
Study Design and Protocol for a Randomized Controlled Trial to Assess Long-Term Efficacy and Safety of a Triple Combination of Ezetimibe, Fenofibrate, and Moderate-Intensity Statin in Patients with Type 2 Diabetes and Modifiable Cardiovascular Risk Factors (ENSEMBLE): Nam Hoon Kim, Juneyoung Lee, Suk Chon, Jae Myung Yu, In-Kyung Jeong, Soo Lim, Won Jun Kim, Keeho Song, Ho Chan Cho, Hea Min Yu, Kyoung-Ah Kim, Sang Soo Kim, Soon Hee Lee, Chong Hwa Kim, Soo Heon Kwak, Yong‐ho Lee, Choon Hee Chung, Sihoon Lee, Heung Yong Jin, Jae Hyuk Lee, Gwanpyo Koh, Sang-Yong Kim, Jaetaek Kim, Ju Hee Lee, Tae Nyun Kim, Hyun Jeong Jeon, Ji Hyun Lee, Jae-Han Jeon, Hye Jin Yoo, Hee Kyung Kim, Hyeong-Kyu Park, Il Seong Nam-Goong, Seongbin Hong, Chul Woo Ahn, Ji Hee Yu, Jong Heon Park, Keun-Gyu Park, Chan Ho Park, Kyong Hye Joung, Ohk-Hyun Ryu, Keun Yong Park, Eun-Gyoung Hong, Bong-Soo Cha, Kyu Chang Won, Yoon-Sok Chung, Sin Gon Kim; Endocrinol Metab. 2024;39(5):722-731. Published online August 22, 2024; DOI: https://doi.org/10.3803/EnM.2024.1995

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Background
Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined.
Methods
This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months.
Conclusion
This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Citations

Citations to this article as recorded by

Beyond lipids: fenofibrate in diabetic retinopathy and nephropathy
Mengying Liu, Seok Ting Lim, Weihua Song, Thomas M. Coffman, Xiaomeng Wang
Trends in Pharmacological Sciences.2026; 47(3): 325. CrossRef
Differential Pre‐ and Post‐Treatment Effects of Low‐Dose Antidyslipidemic Drugs on Gentamicin‐Induced Acute Nephrotoxicity in the Rat: A Histopathological and Biochemical Study
Pitchai Balakumar, Sultan Alshahrani, Noohu Abdulla Khan, Rajavel Varatharajan, K. M. Sundram
Journal of Applied Toxicology.2026; 46(6): 1879. CrossRef
Ezetimibe attenuates diabetic retinopathy via NRF2-mediated suppression of inflammation and oxidative stress
Lei Cheng, Shan Cheng, Ran Zhu, Guoxu Xu
Journal of Diabetes and its Complications.2026; 40(2): 109250. CrossRef
Development and Validation of Green UV Spectrophotometric Method Using Augmented Classical Least Squares for Simultaneous Quantification of Atorvastatin, Ezetimibe, and Fenofibrate in Pharmaceutical and Environmental Samples
Ahmed M. Abdelzaher, Omkulthom Al kamaly, Anwar M. Alnakhli, Mona A. Abdel Rahman
ChemistrySelect.2026;[Epub] CrossRef
Current and Emerging Treatment Options for Hypertriglyceridemia: State-of-the-Art Review
Jakub Michal Zimodro, Manfredi Rizzo, Ioanna Gouni-Berthold
Pharmaceuticals.2025; 18(2): 147. CrossRef
Fenofibrate therapy and risk of heart failure outcomes in patients with Type 2 diabetes: a propensity-matched cohort study
Ji Yoon Kim, Nam Hoon Kim, Jiyoon Lee, Dong-Hoon Kim, Sin Gon Kim
European Heart Journal - Cardiovascular Pharmacotherapy.2025; 11(7): 620. CrossRef

Clinical Study
Efficacy and Safety of Pitavastatin in a Real-World Setting: Observational Study Evaluating SaFety in Patient Treated with Pitavastatin in Korea (PROOF Study): In-Kyung Jeong, Sung-Rae Kim; Endocrinol Metab. 2020;35(4):882-891. Published online December 2, 2020; DOI: https://doi.org/10.3803/EnM.2020.723

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Background
While randomized controlled trials provide useful information about drug safety and efficacy, they do not always reflect the observed results in the real world. The prospective, observational, non-comparative trial in South Korea was designed to evaluate the efficacy and safety of pitavastatin in clinical practice in 28,343 patients.
Methods
This study was conducted in 893 facilities in Korea from April 2, 2012 to April 1, 2017. This study was designed to administer 1, 2, or 4 mg pitavastatin to patients with hyperlipidemia at the age of 20 or older for at least 8 weeks.
Results
For 126 days of mean duration of administration of pitavastatin, the % change of low density lipoprotein cholesterol indicated a dose dependent reduction: –23.4%, –29.1%, and –35.2% in the 1, 2, and 4 mg groups, respectively in patients who have not been treated with lipid lowering medications prior to study. Only 1.74% (492/28,343) of pitavastatin-treated patients experienced adverse events, of which 0.43% (123/28,343) were adverse drug reactions. Less than 1% of patients experienced the grade 2 or more toxicity (Common Terminology Criteria for Adverse Events v4.03) in alanine aminotransferase, aspartate aminotransferase, serum creatinine, and serum creatine phosphokinase. Although there were no rhabdomyolysis in 28,343 patients, 0.04% of patients had been reported pitavastatin-related musculoskeletal disorders.
Conclusion
Overall, this observational study showed that pitavastatin was well tolerated and effectively modified the lipid profile, reducing cardiovascular and cerebrovascular risk in Korean patients with hypercholesterolemia in the real world.

Citations

Citations to this article as recorded by

A hierarchical risk assessment framework for head-to-head comparison of statin safety profiles in Chinese patients
Leo Tsui, Dan Wang, Chuyun Fan, Chengling Shi
Scientific Reports.2026;[Epub] CrossRef
Combination pitavastatin–ezetimibe therapy for hypercholesterolemia and mixed dyslipidemia: a systematic review and meta-analysis
Muhammad Sharjeel Abbas, Asia Batool, Muhammad Hussain, Muhammad Hassan, Asharib Sohaib, Taha Ahmed, Maryam Athar, Saifullah Khan, Warisha Kanwal, Makhzan Ali Akbar, Abdul Hannan
Future Cardiology.2026; 22(6): 607. CrossRef
Cost-Effectiveness Analysis of Pitavastatin in Dyslipidemia: Vietnam Case
Nam Xuan Vo, Hanh Thi My Nguyen, Nhat Manh Phan, Huong Lai Pham, Tan Trong Bui, Tien Thuy Bui
Healthcare.2025; 13(19): 2494. CrossRef
Systematic Review on Efficacy, Effectiveness, and Safety of Pitavastatin in Dyslipidemia in Asia
Nam Xuan Vo, Huong Lai Pham, Tan Trong Bui, Tien Thuy Bui
Healthcare.2024; 13(1): 59. CrossRef
Polymorphic form K of Pitavastatin calcium: an advance in stability and pharmaceutical applications
Renan Marcel Bonilha Dezena
Pharmacy & Pharmacology International Journal.2024; 12(5): 191. CrossRef
Low-Density Lipoprotein Cholesterol Level, Statin Use and Myocardial Infarction Risk in Young Adults
Heekyoung Jeong, Kyungdo Han, Soon Jib Yoo, Mee Kyoung Kim
Journal of Lipid and Atherosclerosis.2022; 11(3): 288. CrossRef

Brief Report

Hypothalamus and Pituitary gland
Reference Ranges of Serum Insulin-Like Growth Factor-I and Insulin-Like Growth Factor Binding Protein-3: Results from a Multicenter Study in Healthy Korean Adults: In-Kyung Jeong, Jong Kyu Byun, Junghyun Noh, Sang Wan Kim, Yoon-Sok Chung, Tae Sun Park, Sung-Woon Kim; Endocrinol Metab. 2020;35(4):954-959. Published online December 1, 2020; DOI: https://doi.org/10.3803/EnM.2020.785

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Insulin-like growth factor-I (IGF-I) plays a pivotal role in the diagnosis and treatment of growth hormone (GH) excess or deficiency. The GH study group of the Korean Endocrine Society aims to establish the Korean reference ranges of serum IGF-I and insulin-like growth factor binding protein-3 (IGFBP-3) and assess the relationship between IGF-I and IGFBP-3 and clinical parameters. Fasting serum was collected from healthy Korean adults at health promotion centers of five hospitals nationwide. Serum IGF-I and IGFBP-3 were measured via an immunoradiometric assay using a DSL kit (Diagnostic Systems Laboratories). Serum samples from 354 subjects (180 male, 174 female) were analyzed based on sex at 10-year intervals from 21 to 70 years. IGF-I levels were inversely correlated with age. After adjustment of age, the IGF-I/IGFBP-3 ratio was significantly negatively associated with blood pressure and free thyroxine and positively associated with weight, hemoglobin, creatinine, alanine transferase, fasting glucose, and thyroid stimulating hormone. Therefore, age- and sex-specific reference ranges of serum IGF-I and IGFBP-3 can be efficient in evaluating GH excess or deficiency in Korean population.

Citations

Citations to this article as recorded by

Surgical outcomes of endoscopic endonasal surgery for nonfunctioning pituitary adenoma in elderly patients: a comprehensive analysis beyond age
Sun Mo Nam, Jong Ha Hwang, Hye Seok Park, Seung Shin Park, Jung Hee Kim, Min-Sung Kim, Chul-Kee Park, Hee-Pyoung Park, Yong Hwy Kim
BMC Endocrine Disorders.2026;[Epub] CrossRef
Serum IGF-1 and IGFBP-3 levels in healthy Korean men aged 19–40 years: a cross-sectional analysis of reference ranges and seasonal variation
Soo-Min Jung, Shi-Hyang Lee, Hyoeun Lee, Eun Na Kim, Kyun-Seop Bae
Translational and Clinical Pharmacology.2025; 33(3): 145. CrossRef
Association of Uterine Leiomyoma with Type 2 Diabetes Mellitus in Young Women: A Population-Based Cohort Study
Ji-Hee Sung, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
Diabetes & Metabolism Journal.2024; 48(6): 1105. CrossRef
Capillary blood as a complementary matrix for doping control purposes. Application to the definition of the individual longitudinal profile of IGF-1
Carlotta Stacchini, Francesco Botrè, Xavier de la Torre, Monica Mazzarino
Journal of Pharmaceutical and Biomedical Analysis.2023; 227: 115274. CrossRef

Case Report

Adrenal gland
Acromegaly with Normal Insulin-Like Growth Factor-1 Levels and Congestive Heart Failure as the First Clinical Manifestation: Hyae Min Lee, Sun Hee Lee, In-Ho Yang, In Kyoung Hwang, You Cheol Hwang, Kyu Jeung Ahn, Ho Yeon Chung, Hui-Jeong Hwang, In-Kyung Jeong; Endocrinol Metab. 2015;30(3):395-401. Published online December 9, 2014; DOI: https://doi.org/10.3803/EnM.2015.30.3.395

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The leading cause of morbidity and mortality in patients with acromegaly is cardiovascular complications. Myocardial exposure to excessive growth hormone can cause ventricular hypertrophy, hypertension, arrhythmia, and diastolic dysfunction. However, congestive heart failure as a result of systolic dysfunction is observed only rarely in patients with acromegaly. Most cases of acromegaly exhibit high levels of serum insulin-like growth factor-1 (IGF-1). Acromegaly with normal IGF-1 levels is rare and difficult to diagnose. Here, we report a rare case of an acromegalic patient whose first clinical manifestation was severe congestive heart failure, despite normal IGF-1 levels. We diagnosed acromegaly using a glucose-loading growth hormone suppression test. Cardiac function and myocardial hypertrophy improved 6 months after transsphenoidal resection of a pituitary adenoma.

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Acromegaly presenting with normal insulin-like growth factor-1 levels in a patient with advanced liver cirrhosis
Ciara Kilcoyne, Kevin Burke, Michael W O’Reilly, Masood Iqbal, Mark Sherlock
BMJ Case Reports.2026; 19(2): e266505. CrossRef
A Case of Heart Failure With Reduced Ejection Fraction Secondary to Dilated Cardiomyopathy due to Long‐Standing Untreated Acromegaly: A Case Report and Focused Literature Review
Cristian Orlando Porras Bueno, Nancy Muriel Herrera Leaño, María Juliana Soto Chávez, Darío Parra Prieto, Alejandro Mariño Correa
Clinical Case Reports.2026;[Epub] CrossRef
The effect of first intervention on cardiac parameters in patients with acromegaly: a systematic review
Kevin A Huynh, Jin Al-Gully, José M Montero-Cabezas, Linda E Scheffers, Marco J T Verstegen, Nienke R Biermasz, Eva C Coopmans
European Journal of Endocrinology.2025; 192(2): S1. CrossRef
From Subtle Signs to Severe Sequelae—A Century of Symptomatology and Comorbidities in the Diagnosis of GH-Secreting Pituitary Neuroendocrine Tumors: A Systematic Review
María José Ayora, Lizeth Vinueza-Mera, Santiago Aynaguano, David Poma Jimenez, Felipe Loza Hernandez, Sebastian Jara Jimenez, Jose A. Rodas, Jose E. Leon-Rojas
Diagnostics.2025; 15(17): 2137. CrossRef
Risk of Neurodegenerative Diseases in Patients With Acromegaly
Sangmo Hong, Kyungdo Han, Kyung-Soo Kim, Cheol-Young Park
Neurology.2022;[Epub] CrossRef
Levels of Serum IGF-1, HCY, and Plasma BNP in Patients with Chronic Congestive Heart Failure and Their Relationship with Cardiac Function and Short-Term Prognosis
Zhengyi Hu, Leifang Mao, Ling Wang, Weiguo Li
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Neurofibromatosis Type 1 with Concurrent Multiple Endocrine Disorders: Adenomatous Goiter, Primary Hyperparathyroidism, and Acromegaly
Shigemitsu Yasuda, Ikuo Inoue, Akira Shimada
Internal Medicine.2021; 60(15): 2451. CrossRef
Metformin stimulates IGFBP-2 gene expression through PPARalpha in diabetic states
Hye Suk Kang, Ho-Chan Cho, Jae-Ho Lee, Goo Taeg Oh, Seung-Hoi Koo, Byung-Hyun Park, In-Kyu Lee, Hueng-Sik Choi, Dae-Kyu Song, Seung-Soon Im
Scientific Reports.2016;[Epub] CrossRef

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