Endocrinology and Metabolism

Original Article

Obesity and Metabolism
Adiposity in the Relationship between Serum Vitamin D Level and Insulin Resistance in Middle-Aged and Elderly Korean Adults: The Korea National Health and Nutrition Examination Survey 2008: Ji Hyun Kang, Sang Soo Kim, Seung Su Moon, Won Jin Kim, Min Jung Bae, Bo Gwang Choi, Yun Kyung Jeon, Bo Hyun Kim, Yong Ki Kim, In Joo Kim; Endocrinol Metab. 2013;28(2):96-102. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.96

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Background

The role of adiposity in the relationship between serum vitamin D levels and insulin resistance has not yet been fully studied. This aim of this study is to clarify the role of adiposity in the relationship between serum vitamin D level and insulin resistance among middle-aged and elderly Korean adults.

Methods

We used data from 2,710 individuals aged ≥50 years based on national data from a representative sample of the fourth Korea National Health and Nutrition Examination Survey IV-2 in 2008.

Results

After adjustment for potential confounders, body mass index (BMI) was significantly associated with 25(OH) vitamin D (P=0.008). However, waist circumference was not significantly associated with 25(OH) vitamin D. In the stratified analyses, 25(OH) vitamin D was found to be negatively associated with fasting insulin and homeostasis model assessment estimate of insulin resistance (HOMA-IR) in participants with BMIs ≥25 kg/m² (P=0.003 for both insulin and HOMR-IR) but was not found to be associated in those with BMIs <23 kg/m². However, we observed a significant inverse in the association of 25(OH) vitamin D with fasting insulin and HOMA-IR in both the normal (P=0.001 and P<0.001 and the abdominally obese group (P=0.010 and P=0.009) in the stratified analyses according to abdominal obesity.

Conclusion

Our results support that the idea that endogenously-produced vitamin D might be stored in subcutaneous fat deposits. In addition, the association of vitamin D with insulin resistance in middle-aged and elderly Korean adults was stronger when it was stratified by BMI than when abdominal obesity status.

Citations

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Case Reports

Pancytopenia Associated with Hypopituitarism in an Acromegaly Patient: A Case Report and a Review of the Literature.: Jung Hee Koh, Yong Jae Lee, Ji Hyun Kang, Bo Kwang Choi, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, In Joo Kim; Endocrinol Metab. 2012;27(4):308-313. Published online December 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.4.308

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Abstract PDF

We present the case of a patient with acromegaly who had pancytopenia with hypopituitarism secondary to the excision of a pituitary macroadenoma and radiation therapy. A 28-year-old man presented with pancytopenia and serum electrolyte abnormalities. He was diagnosed with acromegaly and underwent surgery and gamma-knife radiotherapy for a pituitary macroadenoma at the age of 22 years. A recent brain magnetic resonance imaging showed an empty sella, and the basal hormonal profile demonstrated deficiencies of pituitary hormones except thyrotropin. As presenting pancytopenia, his bone marrow biopsy showed hypocellular marrow. The total number of hemocytes increased after hydrocortisone replacement. Hypopituitarism was a possible cause of pancytopenia, and glucocorticoids had crucial effects on converting pancytopenia to normal in this case.

Citations

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A Case of Actinomycotic Thyroiditis in an Adult with Piriform Sinus Fistula.: Hyun Ju Choi, Bo Won Kim, Min Ji Shin, Bo Kwang Choi, Ji Hyun Kang, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, In Ju Kim, Yong Ki Kim; Endocrinol Metab. 2012;27(3):222-226. Published online September 19, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.3.222

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Abstract PDF

Acute suppurative thyroiditis is an uncommon infectious thyroid disease affecting mainly children and young adults. The route of infection is frequently a pyriform sinus fistula. The major pathogens responsible for acute bacterial suppurative thyroiditis are the Streptococcus and Staphylococcus species. In contrast, Actinomyces species are a very rare cause of acute suppurative thyroiditis. We experienced a case of a 23-year-old man who has presented general weakness and neck pain. Thyroid ultrasonography showed an ill-defined area of heterogeneous hypoechogenicity in the left lobe of the thyroid gland. Histologic examination by fine needle aspiration demonstrated gram-positive, filamentous-like organisms with branching hyphae and characteristic sulfur granules. Barium esophagogram showed a linear barium-filled track at the left pyriform sinus. We report a case of actinomycotic thyroiditis in a young adult with pyriform sinus fistula along with a brief review of related literature.

Citations

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A Case of Pyriform Sinus Fistula Concurrent with Papillary Thyroid Carcinoma in a 72-Year-Old Patient
Yun Young Jung, Dongbin Ahn, Heejin Kim, Jin Ho Sohn
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2015; 58(1): 48. CrossRef

Original Article

Predictive Factors for Incidental Contralateral Carcinoma in Patients with Unilateral Micropapillary Thyroid Carcinoma.: Jung Eun Huh, Sang Soo Kim, Ji Hyun Kang, Bo Gwang Choi, Byung Joo Lee, Jin Choon Lee, Yun Kyung Jeon, Bo Hyun Kim, Soo Geun Wang, Yong Ki Kim, In Joo Kim; Endocrinol Metab. 2012;27(3):194-199. Published online September 19, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.3.194

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Abstract PDF

BACKGROUND
Whether thyroid lobectomy alone is a sufficient treatment for papillary thyroid microcarcinoma (PTMC) remains controversial. The aim of this study is to evaluate the predictive factors for incidental contralateral carcinoma in patients confirmed of unilateral PTMC preoperatively. METHODS: Between January 2007 and December 2009, 393 patients underwent thyroid surgery for unifocal and unilateral PTMC preoperatively at Pusan National University Hospital. A total thyroidectomy with central neck dissection was routinely performed for these patients during this study period. RESULTS: Among the 393 cases in the cohort, 77 patients (19.6%) had incidental PTMC in the contralateral lobe. In patients with incidental contralateral carcinoma, there was higher prevalence in extrathyroid extension, occult ipsilateral carcinoma, pathologic Hashimoto's thyroiditis, and central lymph node metastasis compared to those without contralateral carcinoma. The mean tumor size also increased in patients with contralateral carcinoma. Multivariate logistic regression showed that extrathyroid extension (P = 0.049), occult ipsilateral carcinoma (P < 0.001), pathologic Hashimoto's thyroiditis (P = 0.038), and central lymph node metastasis (P = 0.002) were predictive factors for incidental contralateral carcinoma. CONCLUSION: In conclusion, multifocality in the ipsilateral lobe, central lymph node metastasis, extrathyroid extension, and Hashimoto's thyroiditis is associated with the presence of contralateral carcinoma. Thus, if these factors are found by preoperative and/or postoperative evaluation, total thyroidectomy or completion thyroidectomy is necessary for the treatment of PTMC.

Citations

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Extent of surgery did not affect recurrence during 7‐years follow‐up in papillary thyroid cancer sized 1‐4 cm: Preliminary results
Min Joo Kim, Myung‐Chul Lee, Guk Haeng Lee, Hoon Sung Choi, Sun Wook Cho, Su‐jin Kim, Kyu Eun Lee, Young Joo Park, Do Joon Park
Clinical Endocrinology.2017; 87(1): 80. CrossRef

Case Report

A Case of Bilateral Struma Ovarii Combined with Subclinical Hyperthyroidism.: Sang Mi Kim, Bo Kwang Choi, Ji Hyun Kang, Mi Ra Kim, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, In Ju Kim; Endocrinol Metab. 2012;27(1):72-76. Published online March 1, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.1.72

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Abstract PDF

Struma ovarii is a rare monodermal variant of ovarian teratoma accounting for only 2% of all mature teratomas. To be classified as a struma ovarii, teratoma must be composed predominantly of mature thyroid tissue (> 50%). This tumor is generally benign, although malignant transformation has been reported. Struma ovarii occur mostly as unilateral cases, so bilateral cases are quite rare (less than 6% of cases). Struma ovarii occur largely without symptoms or are accompanied by non-specific symptoms, such as abdominal pain, a palpable abdominal mass, and abdominal distension. The preoperative diagnosis is generally difficult. The incidence of hyperthyroidism has been reported to be 5-10% of patients with struma ovarii. Thus, cases of functional bilateral struma ovarii are very rare. We report a case of bilateral struma ovarii with subclinical thyrotoxicosis and a diffuse goiter, mimicking a malignant ovarian tumor, and include a brief review of related literature.

Citations

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Benign Teratoma of the Thyroid Gland
Chan Young Oak, Hee Kyung Kim, Tae Mi Yoon, Sang Chul Lim, Hyun Bum Park, Hyung Chul Park, Min Gui Han, Ho-Cheol Kang
Endocrinology and Metabolism.2013; 28(2): 144. CrossRef
Metastatic follicular struma ovarii complicating pregnancy: a case report and review of the literature
Woohyung Lee, Nam-Joon Yi, Hyeyoung Kim, Youngrok Choi, Minsu Park, Geun Hong, June Young Choi, Hyun Hoon Chung, Kwang-Woong Lee, Do-Joon Park, Hye Sook Min, June-key Chung, Kyung-Suk Suh
Korean Journal of Hepato-Biliary-Pancreatic Surgery.2012; 16(3): 123. CrossRef

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