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21 "Mee Kyoung Kim"
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Review Article
Diabetes, obesity and metabolism
Epidemiology and Trends of Obesity and Bariatric Surgery in Korea
Kyungdo Han, Jin-Hyung Jung, Su-Min Jeong, Mee Kyoung Kim
Endocrinol Metab. 2024;39(5):678-685.   Published online August 2, 2024
DOI: https://doi.org/10.3803/EnM.2024.2056
  • 863 View
  • 51 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
The prevalence of obesity in Korea has steadily increased over the past decade, reaching 38.4% in 2021. Notably, the rate of class II– III obesity, defined as a body mass index (BMI) of 30 kg/m2 or higher, exceeded 7% in the same year. Since January 2019, the National Health Insurance Service (NHIS) has provided coverage for bariatric surgery (BS) for eligible patients. Coverage is available for individuals with a BMI of 35 kg/m2 or higher, or those with a BMI of 30 kg/m2 or higher who also have obesity-related comorbidities. Additionally, partial reimbursement is offered for BS in patients with type 2 diabetes mellitus who have BMI values between 27.5 and 30 kg/m2. From 2019 to 2022, the NHIS recorded 9,080 BS procedures, with sleeve gastrectomy being the most commonly performed. The average percentage of weight loss 198±99.7 days post-surgery was 17.9%, with 80.0% of patients losing more than 10% of their body weight. This article presents the trends in obesity and BS in Korea.
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Editorial
Diabetes, obesity and metabolism
Younger-Onset Diabetes: Is the Age of Onset More Important than the Duration of Diabetes?
Mee Kyoung Kim
Endocrinol Metab. 2024;39(1):90-91.   Published online February 22, 2024
DOI: https://doi.org/10.3803/EnM.2024.102
  • 1,789 View
  • 60 Download
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Original Articles
Diabetes, obesity and metabolism
Risk of Pancreatic Cancer and Use of Dipeptidyl Peptidase 4 Inhibitors in Patients with Type 2 Diabetes: A Propensity Score-Matching Analysis
Mee Kyoung Kim, Kyungdo Han, Hyuk-Sang Kwon, Soon Jib Yoo
Endocrinol Metab. 2023;38(4):426-435.   Published online July 20, 2023
DOI: https://doi.org/10.3803/EnM.2023.1737
  • 3,779 View
  • 166 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The effects of dipeptidyl peptidase 4 (DPP-4) inhibitors over the course of long-term treatment remain unclear, and concerns have been raised regarding the role of DPP-4 inhibitors in carcinogenesis in the pancreas. Earlier studies of pancreatic adverse events have reported conflicting results.
Methods
This study analyzed Korean National Health Insurance Service data from January 2009 to December 2012. Patients who had type 2 diabetes mellitus and took two or more oral glucose-lowering drugs (GLDs) were included. Patients prescribed DPP-4 inhibitors (n=51,482) or other GLDs (n=51,482) were matched at a 1:1 ratio using propensity score matching. The risk of pancreatic cancer was calculated using Kaplan-Meier curves and Cox proportional-hazards regression analysis.
Results
During a median follow-up period of 7.95 years, 1,051 new cases of pancreatic cancer were identified. The adjusted hazard ratio (HR) for DPP-4 inhibitor use was 0.99 (95% confidence interval [CI], 0.88 to 1.12) compared with the other GLD group. In an analysis limited to cases diagnosed with pancreatic cancer during hospitalization, the adjusted HR for the use of DPP-4 inhibitors was 1.00 (95% CI, 0.86 to 1.17) compared with patients who took other GLDs. Using the other GLD group as the reference group, no trend was observed for elevated pancreatic cancer risk with increased DPP-4 inhibitor exposure.
Conclusion
In this population-based cohort study, DPP-4 inhibitor use over the course of relatively long-term follow-up showed no significant association with an elevated risk of pancreatic cancer.

Citations

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  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
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Calcium & bone metabolism
Persistence with Denosumab in Male Osteoporosis Patients: A Real-World, Non-Interventional Multicenter Study
Chaiho Jeong, Jeongmin Lee, Jinyoung Kim, Jeonghoon Ha, Kwanhoon Jo, Yejee Lim, Mee Kyoung Kim, Hyuk-Sang Kwon, Tae-Seo Sohn, Ki-Ho Song, Moo Il Kang, Ki-Hyun Baek
Endocrinol Metab. 2023;38(2):260-268.   Published online April 27, 2023
DOI: https://doi.org/10.3803/EnM.2023.1663
  • 2,722 View
  • 127 Download
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Persistence with denosumab in male patients has not been adequately investigated, although poor denosumab persistence is associated with a significant risk of rebound vertebral fractures.
Methods
We retrospectively evaluated 294 Korean male osteoporosis patients treated with denosumab at three medical centers and examined their persistence with four doses of denosumab injection over 24 months of treatment. Persistence was defined as the extent to which a patient adhered to denosumab treatment in terms of the prescribed interval and dose, with a permissible gap of 8 weeks. For patients who missed their scheduled treatment appointment(s) during the follow-up period (i.e., no-shows), Cox proportional regression analysis was conducted to explore the factors associated with poor adherence. Several factors were considered, such as age, prior anti-osteoporotic drug use, the treatment provider’s medical specialty, the proximity to the medical center, and financial burdens of treatment.
Results
Out of 294 male patients, 77 (26.2%) completed all four sequential rounds of the denosumab treatment. Out of 217 patients who did not complete the denosumab treatment, 138 (63.6%) missed the scheduled treatment(s). Missing treatment was significantly associated with age (odds ratio [OR], 1.03), prior bisphosphonate use (OR, 0.76), and prescription by non-endocrinologists (OR, 2.24). Denosumab was stopped in 44 (20.3%) patients due to medical errors, in 24 (11.1%) patients due to a T-score improvement over –2.5, and in five (2.3%) patients due to expected dental procedures.
Conclusion
Our study showed that only one-fourth of Korean male osteoporosis patients were fully adherent to 24 months of denosumab treatment.

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  • Denosumab

    Reactions Weekly.2023; 1963(1): 206.     CrossRef
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Review Article
Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
Endocrinol Metab. 2023;38(1):10-24.   Published online February 9, 2023
DOI: https://doi.org/10.3803/EnM.2023.102
  • 5,413 View
  • 289 Download
  • 17 Web of Science
  • 19 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
The Korean National Health Information Database (NHID) contains big data combining information obtained from the National Health Insurance Service and health examinations. Data are provided in the form of a cohort, and the NHID can be used to conduct longitudinal studies and research on rare diseases. Moreover, data on the cause and date of death are provided by Statistics Korea. Research and publications based on the NHID have increased explosively in the field of endocrine disorders. However, because the data were not collected for research purposes, studies using the NHID have limitations, particularly the need for the operational definition of diseases. In this review, we describe the characteristics of the Korean NHID, operational definitions of endocrine diseases used for research, and an overview of recent studies in endocrinology using the Korean NHID.

Citations

Citations to this article as recorded by  
  • Weight change in patients with new‐onset type 2 diabetes mellitus and its association with remission: Comprehensive real‐world data
    Jinyoung Kim, Bongseong Kim, Mee Kyoung Kim, Ki‐Hyun Baek, Ki‐Ho Song, Kyungdo Han, Hyuk‐Sang Kwon
    Diabetes, Obesity and Metabolism.2024; 26(2): 567.     CrossRef
  • Diabetes severity and the risk of depression: A nationwide population-based study
    Yunjung Cho, Bongsung Kim, Hyuk-Sang Kwon, Kyungdo Han, Mee Kyoung Kim
    Journal of Affective Disorders.2024; 351: 694.     CrossRef
  • Information Bias Might Exaggerate Lung Cancer Risk of Patients With Rheumatoid Arthritis
    Nobuyuki Horita, Kaoru Takase-Minegishi
    Journal of Thoracic Oncology.2024; 19(2): 348.     CrossRef
  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
  • Risk of fracture in patients with myasthenia gravis: a nationwide cohort study in Korea
    Hye-Sun Park, Kyoungsu Kim, Min Heui Yu, Ha Young Shin, Yumie Rhee, Seung Woo Kim, Namki Hong
    Journal of Bone and Mineral Research.2024; 39(6): 688.     CrossRef
  • All-cause and cause-specific mortality risks in individuals with diabetes living alone: A large-scale population-based cohort study
    Jae-Seung Yun, Kyungdo Han, Bongseong Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Yu-Bae Ahn, Yong-Moon Mark Park, Seung-Hwan Lee
    Diabetes Research and Clinical Practice.2024; 217: 111876.     CrossRef
  • Epidemiology and Trends of Obesity and Bariatric Surgery in Korea
    Kyungdo Han, Jin-Hyung Jung, Su-Min Jeong, Mee Kyoung Kim
    Endocrinology and Metabolism.2024; 39(5): 678.     CrossRef
  • Diabetes severity is strongly associated with the risk of active tuberculosis in people with type 2 diabetes: a nationwide cohort study with a 6-year follow-up
    Ji Young Kang, Kyungdo Han, Seung-Hwan Lee, Mee Kyoung Kim
    Respiratory Research.2023;[Epub]     CrossRef
  • Research on obesity using the National Health Information Database: recent trends
    Eun-Jung Rhee
    Cardiovascular Prevention and Pharmacotherapy.2023; 5(2): 35.     CrossRef
  • Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study
    Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo
    Journal of Clinical Medicine.2023; 12(14): 4799.     CrossRef
  • Risk of Pancreatic Cancer and Use of Dipeptidyl Peptidase 4 Inhibitors in Patients with Type 2 Diabetes: A Propensity Score-Matching Analysis
    Mee Kyoung Kim, Kyungdo Han, Hyuk-Sang Kwon, Soon Jib Yoo
    Endocrinology and Metabolism.2023; 38(4): 426.     CrossRef
  • Associations Between Physical Activity and the Risk of Hip Fracture Depending on Glycemic Status: A Nationwide Cohort Study
    Kyoung Min Kim, Kyoung Jin Kim, Kyungdo Han, Yumie Rhee
    The Journal of Clinical Endocrinology & Metabolism.2023;[Epub]     CrossRef
  • Prevalence, Treatment Status, and Comorbidities of Hyperthyroidism in Korea from 2003 to 2018: A Nationwide Population Study
    Hwa Young Ahn, Sun Wook Cho, Mi Young Lee, Young Joo Park, Bon Seok Koo, Hang-Seok Chang, Ka Hee Yi
    Endocrinology and Metabolism.2023; 38(4): 436.     CrossRef
  • Is Thyroid Dysfunction Associated with Unruptured Intracranial Aneurysms? A Population-Based, Nested Case–Control Study from Korea
    Hyeree Park, Sun Wook Cho, Sung Ho Lee, Kangmin Kim, Hyun-Seung Kang, Jeong Eun Kim, Aesun Shin, Won-Sang Cho
    Thyroid®.2023; 33(12): 1483.     CrossRef
  • Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study
    Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee
    Endocrinology and Metabolism.2023; 38(5): 525.     CrossRef
  • Risk of depression in patients with acromegaly in Korea (2006-2016): a nationwide population-based study
    Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    European Journal of Endocrinology.2023; 189(3): 363.     CrossRef
  • Cumulative effect of impaired fasting glucose on the risk of dementia in middle-aged and elderly people: a nationwide cohort study
    Jin Yu, Kyu-Na Lee, Hun-Sung Kim, Kyungdo Han, Seung-Hwan Lee
    Scientific Reports.2023;[Epub]     CrossRef
  • 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
    Endocrinology and Metabolism.2023; 38(6): 770.     CrossRef
  • Increased Risk of Hip Fracture in Patients with Acromegaly: A Nationwide Cohort Study in Korea
    Jiwon Kim, Namki Hong, Jimi Choi, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Sin Gon Kim, Cheol Ryong Ku
    Endocrinology and Metabolism.2023; 38(6): 690.     CrossRef
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Original Articles
Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Predicting the Risk of Insulin-Requiring Gestational Diabetes before Pregnancy: A Model Generated from a Nationwide Population-Based Cohort Study in Korea
Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
Endocrinol Metab. 2023;38(1):129-138.   Published online January 27, 2023
DOI: https://doi.org/10.3803/EnM.2022.1609
  • 3,252 View
  • 178 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The severity of gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes. We aimed to generate a risk model for predicting insulin-requiring GDM before pregnancy in Korean women.
Methods
A total of 417,210 women who received a health examination within 52 weeks before pregnancy and delivered between 2011 and 2015 were recruited from the Korean National Health Insurance database. The risk prediction model was created using a sample of 70% of the participants, while the remaining 30% were used for internal validation. Risk scores were assigned based on the hazard ratios for each risk factor in the multivariable Cox proportional hazards regression model. Six risk variables were selected, and a risk nomogram was created to estimate the risk of insulin-requiring GDM.
Results
A total of 2,891 (0.69%) women developed insulin-requiring GDM. Age, body mass index (BMI), current smoking, fasting blood glucose (FBG), total cholesterol, and γ-glutamyl transferase were significant risk factors for insulin-requiring GDM and were incorporated into the risk model. Among the variables, old age, high BMI, and high FBG level were the main contributors to an increased risk of insulin-requiring GDM. The concordance index of the risk model for predicting insulin-requiring GDM was 0.783 (95% confidence interval, 0.766 to 0.799). The validation cohort’s incidence rates for insulin-requiring GDM were consistent with the risk model’s predictions.
Conclusion
A novel risk engine was generated to predict insulin-requiring GDM among Korean women. This model may provide helpful information for identifying high-risk women and enhancing prepregnancy care.

Citations

Citations to this article as recorded by  
  • Establishment and validation of a nomogram to predict the neck contracture after skin grafting in burn patients: A multicentre cohort study
    Rui Li, Yangyang Zheng, Xijuan Fan, Zilong Cao, Qiang Yue, Jincai Fan, Cheng Gan, Hu Jiao, Liqiang Liu
    International Wound Journal.2023; 20(9): 3648.     CrossRef
  • Predicting the Need for Insulin Treatment: A Risk-Based Approach to the Management of Women with Gestational Diabetes Mellitus
    Anna S. Koefoed, H. David McIntyre, Kristen S. Gibbons, Charlotte W. Poulsen, Jens Fuglsang, Per G. Ovesen
    Reproductive Medicine.2023; 4(3): 133.     CrossRef
  • Prepregnancy Glucose Levels Within Normal Range and Its Impact on Obstetric Complications in Subsequent Pregnancy: A Population Cohort Study
    Ho Yeon Kim, Ki Hoon Ahn, Geum Joon Cho, Soon-Cheol Hong, Min-Jeong Oh, Hai-Joong Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study
    Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee
    Endocrinology and Metabolism.2023; 38(5): 525.     CrossRef
  • The CHANGED Score—A New Tool for the Prediction of Insulin Dependency in Gestational Diabetes
    Paul Rostin, Selina Balke, Dorota Sroka, Laura Fangmann, Petra Weid, Wolfgang Henrich, Josefine Theresia Königbauer
    Journal of Clinical Medicine.2023; 12(22): 7169.     CrossRef
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Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Cumulative Exposure to High γ-Glutamyl Transferase Level and Risk of Diabetes: A Nationwide Population-Based Study
Ji-Yeon Park, Kyungdo Han, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim, Seung-Hwan Lee
Endocrinol Metab. 2022;37(2):272-280.   Published online April 13, 2022
DOI: https://doi.org/10.3803/EnM.2022.1416
  • 3,881 View
  • 106 Download
  • 6 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Elevated γ-glutamyl transferase (γ-GTP) level is associated with metabolic syndrome, impaired glucose tolerance, and insulin resistance, which are risk factors for type 2 diabetes. We aimed to investigate the association of cumulative exposure to high γ-GTP level with risk of diabetes.
Methods
Using nationally representative data from the Korean National Health Insurance system, 346,206 people who were free of diabetes and who underwent 5 consecutive health examinations from 2005 to 2009 were followed to the end of 2018. High γ-GTP level was defined as those in the highest quartile, and the number of exposures to high γ-GTP level ranged from 0 to 5. Hazard ratio (HR) and 95% confidence interval (CI) for diabetes were analyzed using the multivariable Cox proportional-hazards model.
Results
The mean follow-up duration was 9.2±1.0 years, during which 15,183 (4.4%) patients developed diabetes. There was a linear increase in the incidence rate and the risk of diabetes with cumulative exposure to high γ-GTP level. After adjusting for possible confounders, the HR of diabetes in subjects with five consecutive high γ-GTP levels were 2.60 (95% CI, 2.47 to 2.73) in men and 3.05 (95% CI, 2.73 to 3.41) in women compared with those who never had a high γ-GTP level. Similar results were observed in various subgroup and sensitivity analyses.
Conclusion
There was a linear relationship between cumulative exposure to high γ-GTP level and risk of diabetes. Monitoring and lowering γ-GTP level should be considered for prevention of diabetes in the general population.

Citations

Citations to this article as recorded by  
  • Validation of Estimated Small Dense Low-Density Lipoprotein Cholesterol Concentration in a Japanese General Population
    Keisuke Endo, Ryo Kobayashi, Makito Tanaka, Marenao Tanaka, Yukinori Akiyama, Tatsuya Sato, Itaru Hosaka, Kei Nakata, Masayuki Koyama, Hirofumi Ohnishi, Satoshi Takahashi, Masato Furuhashi
    Journal of Atherosclerosis and Thrombosis.2024; 31(6): 931.     CrossRef
  • 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
    Endocrinology and Metabolism.2023; 38(6): 770.     CrossRef
  • Elevated gamma‐glutamyl transferase to high‐density lipoprotein cholesterol ratio has a non‐linear association with incident diabetes mellitus: A second analysis of a cohort study
    Haofei Hu, Yong Han, Mijie Guan, Ling Wei, Qijun Wan, Yanhua Hu
    Journal of Diabetes Investigation.2022; 13(12): 2027.     CrossRef
  • Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio: A valuable predictor of type 2 diabetes mellitus incidence
    Wangcheng Xie, Bin Liu, Yansong Tang, Tingsong Yang, Zhenshun Song
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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Thyroid
Big Data Articles (National Health Insurance Service Database)
Repeated Low High-Density Lipoprotein Cholesterol and the Risk of Thyroid Cancer: A Nationwide Population- Based Study in Korea
Jinyoung Kim, Mee Kyoung Kim, Ki-Hyun Baek, Ki-Ho Song, Kyungdo Han, Hyuk-Sang Kwon
Endocrinol Metab. 2022;37(2):303-311.   Published online April 6, 2022
DOI: https://doi.org/10.3803/EnM.2021.1332
  • 5,755 View
  • 168 Download
  • 15 Web of Science
  • 15 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
High-density lipoprotein cholesterol (HDL-C) plays an important role in the reverse cholesterol transport pathway and prevents atherosclerosis-mediated disease. It has also been suggested that HDL-C may be a protective factor against cancer. However, an inverse correlation between HDL-C and cancer has not been established, and few studies have explored thyroid cancer.
Methods
The study participants received health checkups provided by the Korean National Health Insurance Service from 2009 to 2013 and were followed until 2019. Considering the variability of serum HDL-C level, low HDL-C level was analyzed by grouping based on four consecutive health checkups. The data analysis was performed using univariate and multivariate Cox proportional hazard regression models.
Results
A total of 3,134,278 total study participants, thyroid cancer occurred in 16,129. In the crude model, the hazard ratios for the association between repeatedly measured low HDL-C levels and thyroid cancer were 1.243, 1.404, 1.486, and 1.680 (P for trend <0.01), respectively, which were significant even after adjusting for age, sex, lifestyle factors, and metabolic diseases. The subgroup analysis revealed that low HDL-C levels likely had a greater impact on the group of patients with central obesity (P for interaction= 0.062), high blood pressure (P for interaction=0.057), impaired fasting glucose (P for interaction=0.051), and hyperlipidemia (P for interaction=0.126).
Conclusion
Repeatedly measured low HDL-C levels can be considered a risk factor for cancer as well as vascular disease. Low HDL-C levels were associated with the risk of thyroid cancer, and this correlation was stronger in a metabolically unhealthy population.

Citations

Citations to this article as recorded by  
  • Association between total cholesterol levels and all-cause mortality among newly diagnosed patients with cancer
    Seohyun Kim, Gyuri Kim, So Hyun Cho, Rosa Oh, Ji Yoon Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim
    Scientific Reports.2024;[Epub]     CrossRef
  • Association between organophosphate flame retardant exposure and lipid metabolism: data from the 2013–2014 National Health and Nutrition Examination Survey
    Fu-Jen Cheng, Kai-Fan Tsai, Kuo-Chen Huang, Chia-Te Kung, Wan-Ting Huang, Huey-Ling You, Shau-Hsuan Li, Chin-Chou Wang, Wen-Chin Lee, Hsiu-Yung Pan
    Frontiers in Public Health.2024;[Epub]     CrossRef
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    Jue Zhang, Ting Zhang, Ye Yao, Xuxing Shen, Yuanyuan Jin, Run Zhang, Lijuan Chen
    Discover Oncology.2024;[Epub]     CrossRef
  • Lipoprotein alterations in endocrine disorders - a review of the recent developments in the field
    Michal Olejarz, Ewelina Szczepanek-Parulska, Marek Ruchala
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Associations Between Metabolic Obesity Phenotypes and Pathological Characteristics of Papillary Thyroid Carcinoma
    Xiuyun Li, Xiujuan Zhang, Li Sun, Lulu Yang, Qihang Li, Zhixiang Wang, Yafei Wu, Ling Gao, Jiajun Zhao, Qingling Guo, Meng Zhou
    Endocrine Practice.2024; 30(7): 624.     CrossRef
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    Jianning Liu, Zhuoying Feng, Ru Gao, Peng Liu, Fangang Meng, Lijun Fan, Lixiang Liu, Yang Du
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Carbohydrate, Lipid, and Apolipoprotein Biomarkers in Blood and Risk of Thyroid Cancer: Findings from the AMORIS Cohort
    Xue Xiao, Yi Huang, Fetemeh Sadeghi, Maria Feychting, Niklas Hammar, Fang Fang, Zhe Zhang, Qianwei Liu
    Cancers.2023; 15(2): 520.     CrossRef
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    Fei Wang, Luo Lu, HuiJuan Chen, Yanhua Yue, Yanting Sun, Feng Yan, Bai He, Rongrong Lin, Weiying Gu
    Annals of Hematology.2023; 102(2): 393.     CrossRef
  • Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database
    Sun Wook Cho, Jung Hee Kim, Han Seok Choi, Hwa Young Ahn, Mee Kyoung Kim, Eun Jung Rhee
    Endocrinology and Metabolism.2023; 38(1): 10.     CrossRef
  • High-density lipoprotein cholesterol and carcinogenesis
    Meijuan Tan, Shijie Yang, Xiequn Xu
    Trends in Endocrinology & Metabolism.2023; 34(5): 303.     CrossRef
  • Low Serum Cholesterol Level Is a Significant Prognostic Factor That Improves CLL-IPI in Chronic Lymphocytic Leukaemia
    Rui Gao, Kaixin Du, Jinhua Liang, Yi Xia, Jiazhu Wu, Yue Li, Bihui Pan, Li Wang, Jianyong Li, Wei Xu
    International Journal of Molecular Sciences.2023; 24(8): 7396.     CrossRef
  • Do metabolic factors increase the risk of thyroid cancer? a Mendelian randomization study
    Weiwei Liang, FangFang Sun
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Assessment of causal association between differentiated thyroid cancer and disordered serum lipid profile: a Mendelian randomization study
    Qiang Ma, Yu Li, Lijuan An, Liang Guo, Xiaokang Liu
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Risk factors and diagnostic prediction models for papillary thyroid carcinoma
    Xiaowen Zhang, Yuyang Ze, Jianfeng Sang, Xianbiao Shi, Yan Bi, Shanmei Shen, Xinlin Zhang, Dalong Zhu
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Exposure to multiple trace elements and thyroid cancer risk in Chinese adults: A case-control study
    Jia-liu He, Hua-bing Wu, Wen-lei Hu, Jian-jun Liu, Qian Zhang, Wei Xiao, Ming-jun Hu, Ming Wu, Fen Huang
    International Journal of Hygiene and Environmental Health.2022; 246: 114049.     CrossRef
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Review Article
Diabetes, Obesity and Metabolism
Recent Updates to Clinical Practice Guidelines for Diabetes Mellitus
Jin Yu, Seung-Hwan Lee, Mee Kyoung Kim
Endocrinol Metab. 2022;37(1):26-37.   Published online February 28, 2022
DOI: https://doi.org/10.3803/EnM.2022.105
  • 21,524 View
  • 1,277 Download
  • 26 Web of Science
  • 28 Crossref
AbstractAbstract PDFPubReader   ePub   
Guidelines for the management of patients with diabetes have become an important part of clinical practice that improve the quality of care and help establish evidence-based medicine in this field. With rapidly accumulating evidence on various aspects of diabetes care, including landmark clinical trials of treatment agents and newer technologies, timely updates of the guidelines capture the most current state of the field and present a consensus. As a leading academic society, the Korean Diabetes Association publishes practice guidelines biennially and the American Diabetes Association does so annually. In this review, we summarize the key changes suggested in the most recent guidelines. Some of the important updates include treatment algorithms emphasizing comorbid conditions such as atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease in the selection of anti-diabetic agents; wider application of continuous glucose monitoring (CGM), insulin pump technologies and indices derived from CGM such as time in range; more active screening of subjects at high-risk of diabetes; and more detailed individualization in diabetes care. Although there are both similarities and differences among guidelines and some uncertainty remains, these updates provide a good approach for many clinical practitioners who are battling with diabetes.

Citations

Citations to this article as recorded by  
  • Finerenone: Efficacy of a New Nonsteroidal Mineralocorticoid Receptor Antagonist in Treatment of Patients With Chronic Kidney Disease and Type 2 Diabetes
    Subo Dey, Jasmine Garg, Andy Wang, Eva Holzner, William H. Frishman, Wilbert S. Aronow
    Cardiology in Review.2024; 32(3): 285.     CrossRef
  • Use of Diabetes Medications before and after a Heart Failure–Related Hospitalization among Nursing Home Residents
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    Hong-Yan Sun, Xiao-Yan Lin
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Close layer
Original Articles
Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes
Seung-Hwan Lee, Kyungdo Han, Hyuk-Sang Kwon, Mee Kyoung Kim
Endocrinol Metab. 2021;36(5):1007-1015.   Published online October 21, 2021
DOI: https://doi.org/10.3803/EnM.2021.1218
  • 4,675 View
  • 135 Download
  • 13 Web of Science
  • 14 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Metabolic abnormalities, such as impaired fasting glucose (IFG), are dynamic phenomena; however, it is unclear whether the timing of IFG exposure and cumulative exposure to IFG are related to cardiovascular disease (CVD) and mortality risk.
Methods
Data were extracted from a nationwide population-based cohort in South Korea for adults (n=2,206,679) who were free of diabetes and had 4 years of consecutive health examination data. Fasting blood glucose levels of 100 to 125 mg/dL were defined as IFG, and the number of IFG diagnoses for each adult in the 4-year period was tabulated as the IFG exposure score (range, 0 to 4). Adults with persistent IFG for the 4-year period received a score of 4.
Results
The median follow-up was 8.2 years. There were 24,820 deaths, 13,502 cases of stroke, and 13,057 cases of myocardial infarction (MI). IFG exposure scores of 1, 2, 3, and 4 were associated with all-cause mortality (multivariable-adjusted hazard ratio [aHR], 1.11; 95% confidence interval [CI], 1.08 to 1.15; aHR, 1.16; 95% CI, 1.12 to 1.20; aHR, 1.20; 95% CI, 1.15 to 1.25; aHR, 1.18; 95% CI, 1.11 to 1.25, respectively) compared with an IFG exposure score of 0. Adjusting for hypertension and dyslipidemia attenuated the slightly increased risk of MI or stroke associated with high IFG exposure scores, but significant associations for allcause mortality remained.
Conclusion
The intensity of IFG exposure was associated with an elevated risk of all-cause mortality, independent of cardiovascular risk factors. The association between IFG exposure and CVD risk was largely mediated by the coexistence of dyslipidemia and hypertension.

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  • Cumulative exposure to impaired fasting glucose and gastrointestinal cancer risk: A nationwide cohort study
    Byeong Yun Ahn, Bokyung Kim, Sanghyun Park, Sang Gyun Kim, Kyungdo Han, Soo‐Jeong Cho
    Cancer.2024; 130(10): 1807.     CrossRef
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    Yunjung Cho, Bongsung Kim, Hyuk-Sang Kwon, Kyungdo Han, Mee Kyoung Kim
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    Jie Liu, Feng Yi, Kai Duan, Haibo Liu
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    Ji Young Kang, Kyungdo Han, Seung-Hwan Lee, Mee Kyoung Kim
    Respiratory Research.2023;[Epub]     CrossRef
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    Cuicui Wang, Xu Zhang, Chenwei Li, Na Li, Xueni Jia, Hui Zhao
    International Journal of General Medicine.2023; Volume 16: 1415.     CrossRef
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    Kyungdo Han, Mee Kyoung Kim
    Journal of Obesity & Metabolic Syndrome.2023; 32(2): 163.     CrossRef
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    Min Cheol Chang, Seung Min Chung, Sang Gyu Kwak
    Reviews on Environmental Health.2023;[Epub]     CrossRef
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    Myung Ji Nam, Hyunjin Kim, Yeon Joo Choi, Kyung-Hwan Cho, Seon Mee Kim, Yong-Kyun Roh, Kyungdo Han, Jin-Hyung Jung, Yong-Gyu Park, Joo-Hyun Park, Do-Hoon Kim
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    Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
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    Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
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  • Low-Density Lipoprotein Cholesterol Level, Statin Use and Myocardial Infarction Risk in Young Adults
    Heekyoung Jeong, Kyungdo Han, Soon Jib Yoo, Mee Kyoung Kim
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Close layer
Bone Metabolism
Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus
Jeonghoon Ha, Yejee Lim, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Ho Song, Seung Hyun Ko, Moo Il Kang, Sung Dae Moon, Ki-Hyun Baek
Endocrinol Metab. 2021;36(4):895-903.   Published online August 9, 2021
DOI: https://doi.org/10.3803/EnM.2021.1026
  • 7,270 View
  • 244 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Prospective comparative studies on the effects of various antidiabetic agents on bone metabolism are limited. This study aimed to assess changes in bone mass and biochemical bone markers in postmenopausal patients with type 2 diabetes mellitus (T2DM).
Methods
This prospective, multicenter, open-label, comparative trial included 264 patients with T2DM. Patients who had received a metformin, or sulfonylurea/metformin combination (Group 1); a thiazolidinedione combination (Group 2); a dipeptidyl peptidase-4 inhibitor (gemigliptin) combination (Group 3); or an sodium-glucose cotransporter 2 inhibitor (empagliflozin) combination (Group 4) were prospectively treated for 12 months; bone mineral density (BMD) and bone turnover marker (BTM) changes were evaluated.
Results
The femoral neck BMD percentage changes were −0.79%±2.86% (Group 1), −2.50%±3.08% (Group 2), −1.05%±2.74% (Group 3), and −1.24%±2.91% (Group 4) (P<0.05). The total hip BMD percentage changes were −0.57%±1.79% (Group 1), −1.74%±1.48% (Group 2), −0.75%±1.87% (Group 3), and −1.27%±1.72% (Group 4) (P<0.05). Mean serum BTM (C-terminal type 1 collagen telopeptide and procollagen type 1 amino-terminal propeptide) levels measured during the study period did not change over time or differ between groups.
Conclusion
Significant bone loss in the femoral neck and total hip was associated with thiazolidinedione combination regimens. However, bone loss was not significantly associated with combination regimens including gemigliptin or empagliflozin. Caution should be exercised during treatment with antidiabetic medications that adversely affect the bone in patients with diabetes at a high risk of bone loss.

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  • Meta-Analysis on the Association Between DPP-4 Inhibitors and Bone Mineral Density and Osteoporosis
    Lili Huang, Wei Zhong, Xinghuan Liang, Huijuan Wang, Shi-en Fu, Zuojie Luo
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    Krisztina Kupai, Hsu Lin Kang, Anikó Pósa, Ákos Csonka, Tamás Várkonyi, Zsuzsanna Valkusz
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    L. M. Pechmann, F. I. Pinheiro, V. F. C. Andrade, C. A. Moreira
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    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 1177.     CrossRef
  • Complementary effects of dapagliflozin and lobeglitazone on metabolism in a diet-induced obese mouse model
    Yun Kyung Lee, Tae Jung Oh, Ji In Lee, Bo Yoon Choi, Hyen Chung Cho, Hak Chul Jang, Sung Hee Choi
    European Journal of Pharmacology.2023; 957: 175946.     CrossRef
Close layer
Clinical Study
Big Data Articles (National Health Insurance Service Database)
Cumulative Exposure to Metabolic Syndrome Components and the Risk of Dementia: A Nationwide Population-Based Study
Yunjung Cho, Kyungdo Han, Da Hye Kim, Yong-Moon Park, Kun-Ho Yoon, Mee Kyoung Kim, Seung-Hwan Lee
Endocrinol Metab. 2021;36(2):424-435.   Published online April 14, 2021
DOI: https://doi.org/10.3803/EnM.2020.935
  • 6,795 View
  • 202 Download
  • 13 Web of Science
  • 13 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Metabolic disturbances are modifiable risk factors for dementia. Because the status of metabolic syndrome (MetS) and its components changes over time, we aimed to investigate the association of the cumulative exposure to MetS and its components with the risk of dementia.
Methods
Adults (n=1,492,776; ≥45-years-old) who received health examinations for 4 consecutive years were identified from a nationwide population-based cohort in Korea. Two exposure-weighted scores were calculated: cumulative number of MetS diagnoses (MetS exposure score, range of 0 to 4) and the composite of its five components (MetS component exposure score, range of 0 to 20). Hazard ratio (HR) and 95% confidence interval (CI) values for dementia were analyzed using the multivariable Cox proportional-hazards model.
Results
Overall, 47.1% of subjects were diagnosed with MetS at least once, and 11.5% had persistent MetS. During the mean 5.2 years of follow-up, there were 7,341 cases (0.5%) of incident dementia. There was a stepwise increase in the risk of all-cause dementia, Alzheimer’s disease, and vascular dementia with increasing MetS exposure score and MetS component exposure score (each P for trend <0.0001). The HR of all-cause dementia was 2.62 (95% CI, 1.87 to 3.68) in subjects with a MetS component exposure score of 20 compared with those with a score of 0. People fulfilling only one MetS component out of 20 already had an approximately 40% increased risk of all-cause dementia and Alzheimer’s disease.
Conclusion
More cumulative exposure to metabolic disturbances was associated with a higher risk of dementia. Of note, even minimal exposure to MetS components had a significant effect on the risk of dementia.

Citations

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    Se Young Jung, Kyungdo Han, Jin Hyung Jung, Hyunsun Park, Dong Wook Shin
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    Tara SR Chen, Ning-Ning Mi, Hubert Yuenhei Lao, Chen-Yu Wang, Wai Leung Ambrose Lo, Yu-Rong Mao, Yan Tang, Zhong Pei, Jin-Qiu Yuan, Dong-Feng Huang
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    Panagiota Kontari, Chris Fife-Schaw, Kimberley Smith, Lewis A Lipsitz
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    Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
    Endocrinology and Metabolism.2023; 38(1): 129.     CrossRef
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    Marcos D. Machado-Fragua, Séverine Sabia, Aurore Fayosse, Céline Ben Hassen, Frank van der Heide, Mika Kivimaki, Archana Singh-Manoux
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    Walaa Fakih, Ralph Zeitoun, Ibrahim AlZaim, Ali H. Eid, Firas Kobeissy, Khaled S. Abd‐Elrahman, Ahmed F. El‐Yazbi
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    Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
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Close layer
Clinical Study
Predicting the Development of Myocardial Infarction in Middle-Aged Adults with Type 2 Diabetes: A Risk Model Generated from a Nationwide Population-Based Cohort Study in Korea
Seung-Hwan Lee, Kyungdo Han, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
Endocrinol Metab. 2020;35(3):636-646.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.704
  • 5,756 View
  • 118 Download
  • 11 Web of Science
  • 13 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Most of the widely used prediction models for cardiovascular disease are known to overestimate the risk of this disease in Asians. We aimed to generate a risk model for predicting myocardial infarction (MI) in middle-aged Korean subjects with type 2 diabetes.
Methods
A total of 1,272,992 subjects with type 2 diabetes aged 40 to 64 who received health examinations from 2009 to 2012 were recruited from the Korean National Health Insurance database. Seventy percent of the subjects (n=891,095) were sampled to develop the risk prediction model, and the remaining 30% (n=381,897) were used for internal validation. A Cox proportional hazards regression model and Cox coefficients were used to derive a risk scoring system. Twelve risk variables were selected, and a risk nomogram was created to estimate the 5-year risk of MI.
Results
During 7.1 years of follow-up, 24,809 cases of MI (1.9%) were observed. Age, sex, smoking status, regular exercise, body mass index, chronic kidney disease, duration of diabetes, number of anti-diabetic medications, fasting blood glucose, systolic blood pressure, total cholesterol, and atrial fibrillation were significant risk factors for the development of MI and were incorporated into the risk model. The concordance index for MI prediction was 0.682 (95% confidence interval [CI], 0.678 to 0.686) in the development cohort and 0.669 (95% CI, 0.663 to 0.675) in the validation cohort.
Conclusion
A novel risk engine was generated for predicting the development of MI among middle-aged Korean adults with type 2 diabetes. This model may provide useful information for identifying high-risk patients and improving quality of care.

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  • A literature review of quality assessment and applicability to HTA of risk prediction models of coronary heart disease in patients with diabetes
    Li Jiu, Junfeng Wang, Francisco Javier Somolinos-Simón, Jose Tapia-Galisteo, Gema García-Sáez, Mariaelena Hernando, Xinyu Li, Rick A. Vreman, Aukje K. Mantel-Teeuwisse, Wim G. Goettsch
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    Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
    Endocrinology and Metabolism.2023; 38(1): 129.     CrossRef
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    Kyungdo Han, Mee Kyoung Kim
    Journal of Obesity & Metabolic Syndrome.2023; 32(2): 163.     CrossRef
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    Dae-Jeong Koo, Mi Yeon Lee, Sun Joon Moon, Hyemi Kwon, Sang Min Lee, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki Won Oh, Sung Rae Cho, Young-Hoon Jeong, Eun-Jung Rhee
    Endocrinology and Metabolism.2023; 38(5): 568.     CrossRef
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    Yichen Jin, Ziyuan Xu, Yuting Zhang, Yue Zhang, Danyang Wang, Yangyang Cheng, Yaguan Zhou, Muhammad Fawad, Xiaolin Xu
    Frontiers in Public Health.2023;[Epub]     CrossRef
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    Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
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    Kyung-Soo Kim, Sangmo Hong, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
    Journal of General Internal Medicine.2022; 37(16): 4153.     CrossRef
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    Mee Kyoung Kim, Kyungdo Han, Bongsung Kim, Jinyoung Kim, Hyuk-Sang Kwon
    Scientific Reports.2022;[Epub]     CrossRef
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    Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
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    Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
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Clinical Study
Consistency of the Glycation Gap with the Hemoglobin Glycation Index Derived from a Continuous Glucose Monitoring System
Han Na Joung, Hyuk-Sang Kwon, Ki-Hyun Baek, Ki-Ho Song, Mee Kyoung Kim
Endocrinol Metab. 2020;35(2):377-383.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.377
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Discordances between glycated hemoglobin (HbA1c) levels and glycemic control are common in clinical practice. We aimed to investigate the consistency of the glycation gap with the hemoglobin glycation index (HGI).
Methods
From 2016 to 2019, 36 patients with type 2 diabetes were enrolled. HbA1c, glycated albumin (GA), and fasting blood glucose levels were simultaneously measured and 72-hour continuous glucose monitoring (CGM) was performed on the same day. Repeated tests were performed at baseline and 1 month later, without changing patients’ diabetes management. The HGI was calculated as the difference between the measured HbA1c and the predicted HbA1c that was derived from CGM. The glycation gap was calculated as the difference between the measured and GA-based predicted HbA1c levels.
Results
Strong correlations were found between the mean blood glucose (MBG)-based HGI and the prebreakfast glucose-based HGI (r=0.867, P<0.001) and between the glycation gap and the MBG-based HGI (r=0.810, P<0.001). A close correlation was found between the MBG-based HGI at baseline and that after 1 month (r=0.729, P<0.001), with a y-intercept of 0 and a positive slope.
Conclusion
The HGI and glycation gap were highly reproducible, and the magnitudes of repeated determinations were closely correlated. Patients with similar mean glucose levels may have significantly different HbA1c levels.

Citations

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  • Factors associated with hemoglobin glycation index in adults with type 1 diabetes mellitus: The FGM‐Japan study
    Naoki Sakane, Yushi Hirota, Akane Yamamoto, Junnosuke Miura, Hiroko Takaike, Sari Hoshina, Masao Toyoda, Nobumichi Saito, Kiminori Hosoda, Masaki Matsubara, Atsuhito Tone, Satoshi Kawashima, Hideaki Sawaki, Tomokazu Matsuda, Masayuki Domichi, Akiko Suganu
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    Klara R Klein, Edward Franek, Steven Marso, Thomas R Pieber, Richard E Pratley, Amoolya Gowda, Kajsa Kvist, John B Buse
    BMJ Open Diabetes Research & Care.2021; 9(2): e002339.     CrossRef
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Review Article
Obesity and Metabolism
Effects of Cardiovascular Risk Factor Variability on Health Outcomes
Seung-Hwan Lee, Mee Kyoung Kim, Eun-Jung Rhee
Endocrinol Metab. 2020;35(2):217-226.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.217
  • 10,790 View
  • 210 Download
  • 28 Web of Science
  • 31 Crossref
AbstractAbstract PDFPubReader   ePub   
Innumerable studies have suggested “the lower, the better” for cardiovascular risk factors, such as body weight, lipid profile, blood pressure, and blood glucose, in terms of health outcomes. However, excessively low levels of these parameters cause health problems, as seen in cachexia, hypoglycemia, and hypotension. Body weight fluctuation is related to mortality, diabetes, obesity, cardiovascular disease, and cancer, although contradictory findings have been reported. High lipid variability is associated with increased mortality and elevated risks of cardiovascular disease, diabetes, end-stage renal disease, and dementia. High blood pressure variability is associated with increased mortality, myocardial infarction, hospitalization, and dementia, which may be caused by hypotension. Furthermore, high glucose variability, which can be measured by continuous glucose monitoring systems or self-monitoring of blood glucose levels, is associated with increased mortality, microvascular and macrovascular complications of diabetes, and hypoglycemic events, leading to hospitalization. Variability in metabolic parameters could be affected by medications, such as statins, antihypertensives, and hypoglycemic agents, and changes in lifestyle patterns. However, other mechanisms modify the relationships between biological variability and various health outcomes. In this study, we review recent evidence regarding the role of variability in metabolic parameters and discuss the clinical implications of these findings.

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