Endocrinology and Metabolism

Original Article

Diabetes, obesity and metabolism Big Data Articles (National Health Insurance Service Database)
The Severity of Diabetes and the Risk of Diabetic Foot Amputation: A National Cohort Study: Jin Yu, Ji-Hyun Kim, Bongseong Kim, Kyungdo Han, Seung Hwan Lee, Mee Kyoung Kim; Endocrinol Metab. 2025;40(4):574-582. Published online April 15, 2025; DOI: https://doi.org/10.3803/EnM.2024.2266

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Background
This study aimed to assess whether markers of diabetes severity could serve as predictors for foot amputation risk among patients with type 2 diabetes mellitus.
Methods
We analyzed data from the nationally representative Korean National Health Insurance System database, tracking 2,544,077 patients with type 2 diabetes mellitus who participated in routine health check-ups between 2009 and 2012, with followup extending through the end of 2018. The parameters used to define the diabetes severity score encompassed diabetes duration, insulin usage, the number of oral glucose-lowering medications, the presence of chronic kidney disease, diabetic retinopathy, and cardiovascular disease. Each factor was assigned one point, yielding a cumulative severity score ranging from 0 to 6.
Results
The risk of diabetic foot amputation was predominantly predicted by insulin therapy, diabetic retinopathy, and a prolonged duration of diabetes. The hazard ratios for foot amputation increased with the severity score as follows: 2.31 (95% confidence interval [CI], 2.15 to 2.47) for a score of 1, 4.73 (95% CI, 4.42 to 5.07) for a score of 2, 8.86 (95% CI, 8.24 to 9.53) for a score of 3, 16.95 (95% CI, 15.60 to 18.4) for a score of 4, 23.98 (95% CI, 21.25 to 27.05) for a score of 5, and 37.87 (95% CI, 28.93 to 49.57) for a score of 6.
Conclusion
Specific markers of advanced diabetes effectively identified patients at an elevated risk for diabetic foot amputation.

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Costos directos y determinantes de las amputaciones en pacientes diabéticos en un hospital de Nicaragua en el año 2024.
Sidley Irania Hurtado Alvarado, Sheila Karina Valdivia Quiroz
Revista Multidisciplinaria Voces de América y el Caribe.2026; 3(1): 12. CrossRef
Diabetes Progression and Its Impact on Kidney Cancer Risk: Insights From a Longitudinal Korean Cohort Study
Jin Yu, Bongseong Kim, Kyungdo Han, Mee Kyoung Kim
The Journal of Clinical Endocrinology & Metabolism.2025; 111(1): e125. CrossRef
Association of high-density lipoprotein-related inflammatory indicators with diabetic foot ulcer in patients with diabetes: a population-based study
Renhe Deng, Ruyi Tao, Huiyi Luo, Yueqi Gu, Mengyu Yang, Chaoqi Yin
Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef

Editorial

Diabetes, obesity and metabolism
Highlights of the Most Recent American Diabetes Association Guidelines: From Evidence to Practice: Mee Kyoung Kim; Endocrinol Metab. 2025;40(1):67-69. Published online February 24, 2025; DOI: https://doi.org/10.3803/EnM.2025.2329

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The Enterolimbic Axis: Gut-Brain Affective Circuits at the Crossroad of Metabolism, Emotion, and Behavior
Antonio Gasbarrini, Francesca Sofia Galli, Gianluca Ianiro, Francesca Ponziani, Emanuele Rinninella
American Journal of Gastroenterology.2026;[Epub] CrossRef

Original Article

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

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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.

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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
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
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.2025; : 1. CrossRef

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

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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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Long-term exposure to ambient air pollutant mixture and metabolic obesity phenotypes: Results from a nationwide Korean study (2007–2019)
Seong-Uk Baek, Jin-Ha Yoon
Journal of Exposure Science & Environmental Epidemiology.2026; 36(1): 175. CrossRef
Metabolic and Bariatric Surgery Evolution Over the Past Decades (2009–2024): Insights from the Iranian National Obesity Surgery Database (INOSD)
Shahab Shahabi Shahmiri, Abdolreza Pazouki, Seyed Amin Setarehdan, Kimia Vakili, Kimia Jazi, Erfan Sheikhbahaei, Fahime Yarigholi, Somayeh Mokhber, Alireza Khalaj, Amir Hossein Davarpanah Jazi, Mohammad Kermansaravi
Obesity Surgery.2026;[Epub] CrossRef
Impact of caloric restriction on diabetes remission in Korean adults with obesity (CREDO‐K study)
Mee Kyoung Kim, Jinyoung Kim, Su‐Jeong Park, Yoon‐Ju Song, Hyuk‐Sang Kwon
Diabetes, Obesity and Metabolism.2025; 27(3): 1609. CrossRef
Diabetes Progression and Its Impact on Kidney Cancer Risk: Insights From a Longitudinal Korean Cohort Study
Jin Yu, Bongseong Kim, Kyungdo Han, Mee Kyoung Kim
The Journal of Clinical Endocrinology & Metabolism.2025; 111(1): e125. CrossRef
Early experience with bariatric surgery by an experienced gastric cancer surgeon in a tertiary center
Jawon Hwang, Shanwen Charleen Yeo, Minah Cho, Yoo Min Kim
Foregut Surgery.2025; 5(2): 63. CrossRef
A Contemporary Perspective on Long-Term Complications of Bariatric Surgery
Vladislav Skossyrskiy, Daniil Stepochkin, Ekaterina Zaharova, Rasim Mamedov, Sergey Muraviev, Regina Pakhomova, Elizaveta German, Andrey Nikolaev, Zelimkhan Berikkhanov, Ivan Markov, Andrey Fabrika, Vadim Razumovsky
Obesity Surgery.2025;[Epub] CrossRef

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

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Cholesterol and Cardiovascular Risk in Type 2 Diabetes: The Role of Kidney Function
Ji-Hyun Kim, Seung-Hwan Lee, Kyu Na Lee, Kyungdo Han, Mee Kyoung Kim
Journal of Lipid and Atherosclerosis.2025; 14(2): 190. CrossRef

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

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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.

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Real-world evidence on the association of novel antidiabetic medication use with cancer risk and protective effects: a systematic review and network meta-analysis
Ahmed S. Kenawy, Yi-Shao Liu, Ayobami Aiyeolemi, Godwin Okoye, Chanhyun Park
Therapeutic Advances in Drug Safety.2025;[Epub] CrossRef
Cholesterol and Cardiovascular Risk in Type 2 Diabetes: The Role of Kidney Function
Ji-Hyun Kim, Seung-Hwan Lee, Kyu Na Lee, Kyungdo Han, Mee Kyoung Kim
Journal of Lipid and Atherosclerosis.2025; 14(2): 190. CrossRef
The Severity of Diabetes and the Risk of Diabetic Foot Amputation: A National Cohort Study
Jin Yu, Ji-Hyun Kim, Bongseong Kim, Kyungdo Han, Seung Hwan Lee, Mee Kyoung Kim
Endocrinology and Metabolism.2025; 40(4): 574. CrossRef
Unusual Manifestations of Primary Pancreatic Neoplasia
Emilia Włoszek, Kamila Krupa, Marta Fudalej, Hanna Miski, Anna M. Badowska-Kozakiewicz, Andrzej Deptała
Cancers.2025; 17(19): 3240. 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; 109(12): e2317. CrossRef
Anti-Diabetic Therapies and Cancer: From Bench to Bedside
Dimitris Kounatidis, Natalia G. Vallianou, Irene Karampela, Eleni Rebelos, Marina Kouveletsou, Vasileios Dalopoulos, Petros Koufopoulos, Evanthia Diakoumopoulou, Nikolaos Tentolouris, Maria Dalamaga
Biomolecules.2024; 14(11): 1479. CrossRef

Mineral, Bone & Muscle
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

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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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Osteoporosis International.2026; 37(1): 81. CrossRef
Denosumab

Reactions Weekly.2023; 1963(1): 206. CrossRef

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

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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.

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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

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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

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Developing a Risk Stratification Tool to Predict Patients with Gestational Diabetes Mellitus at Risk of Insulin Treatment: A Cohort Study
Xi Yang, Hannah L. Nathan, Ebruba E. Oyekan, Tim I. M. Korevaar, Doaa Ahmed, Katherine Pacifico, Aisha Hameed, Manju Chandiramani, Anita Banerjee, Caroline Ovadia
Journal of Personalized Medicine.2025; 15(6): 223. CrossRef
Individual Prediction of Insulin Therapy in Gestational Diabetes: Development of a Risk Calculator Based on Real-World Data from the GestDiab Registry
Friederike Weschenfelder, Barbara Dusek, Heinke Adamczewski, Dietmar Weber, Matthias Kaltheuner, Yvonne Heimann, Tanja Groten
Geburtshilfe und Frauenheilkunde.2025; 85(12): 1334. CrossRef
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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

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

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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.

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Elevated GGT to HDL ratio as a marker for the risk of NAFLD and liver fibrosis
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Investigating the synergistic effects of gamma-glutamyl transferase with homocysteine, ferritin, and uric acid in patients with type II diabetes mellitus
Simin Shirvani, Masomeh Halvaeezade, Maryam Avazzade, Morteza Golbashirzadeh, Atousa Moradzadegan
Endocrine and Metabolic Science.2025; 17: 100211. CrossRef
Association between non-high-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol ratio and the risk of gestational diabetes: a retrospective study
Guohua Li, Dongxing Su, Wei Huang, Xuehua Wu, Yanzhu Huang
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Nonlinear association between gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio and risk of progression from normoglycemia to prediabetes: a 5-year cohort study
Chuang Gao, Cailing Yu, Peijie Shi, Dehong Liu, Qiming Li, Yong Han
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Sex differences in the association between atherogenic index of plasma and progression from normoglycemia to prediabetes: evidence from a 5-year large-scale retrospective cohort study
Chufu Yang, Qiying Chen, Weiyan Li, Chuang Gao, Yong Han, Jiaqian Zhu
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Yoko Yamanouchi, Maiko Osawa, Takaaki Senbonmatsu, Yuki Shiko, Yohei Kawasaki, Toshihiro Muramatsu
Journal of Personalized Medicine.2024; 14(11): 1082. 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

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

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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.

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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

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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.

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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

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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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Mineral, Bone & Muscle
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

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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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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

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226 Download
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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.

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Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
Diabetes & Metabolism Journal.2022; 46(4): 552. CrossRef
Association of Metabolic Syndrome With Incident Dementia: Role of Number and Age at Measurement of Components in a 28-Year Follow-up of the Whitehall II Cohort Study
Marcos D. Machado-Fragua, Aurore Fayosse, Manasa Shanta Yerramalla, Thomas T. van Sloten, Adam G. Tabak, Mika Kivimaki, Séverine Sabia, Archana Singh-Manoux
Diabetes Care.2022; 45(9): 2127. CrossRef
Risk of Neurodegenerative Diseases in Patients With Acromegaly
Sangmo Hong, Kyungdo Han, Kyung-Soo Kim, Cheol-Young Park
Neurology.2022;[Epub] CrossRef

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

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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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Archives of Public Health.2024;[Epub] CrossRef
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
Endocrinology and Metabolism.2023; 38(1): 129. CrossRef
Factors Affecting High Body Weight Variability
Kyungdo Han, Mee Kyoung Kim
Journal of Obesity & Metabolic Syndrome.2023; 32(2): 163. CrossRef
Coronary Artery Calcium Score as a Sensitive Indicator of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus: A Long-Term Cohort Study
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
Serum/plasma biomarkers and the progression of cardiometabolic multimorbidity: a systematic review and meta-analysis
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
Assessing the Validity of the Criteria for the Extreme Risk Category of Atherosclerotic Cardiovascular Disease: A Nationwide Population-Based Study
Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
Journal of Lipid and Atherosclerosis.2022; 11(1): 73. CrossRef
Evaluating Triglyceride and Glucose Index as a Simple and Easy-to-Calculate Marker for All-Cause and Cardiovascular Mortality
Kyung-Soo Kim, Sangmo Hong, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
Journal of General Internal Medicine.2022; 37(16): 4153. CrossRef
Effects of exercise initiation and smoking cessation after new-onset type 2 diabetes mellitus on risk of mortality and cardiovascular outcomes
Mee Kyoung Kim, Kyungdo Han, Bongsung Kim, Jinyoung Kim, Hyuk-Sang Kwon
Scientific Reports.2022;[Epub] CrossRef
Current Trends of Big Data Research Using the Korean National Health Information Database
Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
Diabetes & Metabolism Journal.2022; 46(4): 552. CrossRef
Lipid cutoffs for increased cardiovascular disease risk in non-diabetic young people
Mee Kyoung Kim, Kyungdo Han, Hun-Sung Kim, Kun-Ho Yoon, Seung-Hwan Lee
European Journal of Preventive Cardiology.2022; 29(14): 1866. 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
Nonalcoholic fatty liver disease and the risk of insulin-requiring gestational diabetes
Sang Youn You, Kyungdo Han, Seung-Hawn Lee, Mee Kyoung Kim
Diabetology & Metabolic Syndrome.2021;[Epub] CrossRef

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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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.

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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

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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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Original Article

Clinical Study
Comparison of Natural Course between Thyroid Cancer Nodules and Thyroid Benign Nodules: Kyun-Jin Yun, Jeonghoon Ha, Min-Hee Kim, Ye Young Seo, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Ho Song, Moo Il Kang, Ki-Hyun Baek; Endocrinol Metab. 2019;34(2):195-202. Published online June 24, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.2.195

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Background

The natural course of thyroid cancer nodules and benign nodules is different. This study was to compare the changes in size between thyroid cancer nodules and thyroid benign nodules. The risk factors associated with the changes of thyroid cancer nodules were assessed.

Methods

This study contains retrospective observational and prospective analysis. A total of 113 patients with 120 nodules were recruited in the cancer group, and 116 patients with 119 nodules were enrolled in the benign group. Thyroid ultrasonography was performed at least two times at more than 1-year interval.

Results

The mean follow-up durations were 29.5±18.8 months (cancer group) and 31.9±15.8 months (benign group) (P=0.32). The maximum diameter change in length was 0.36±0.97 mm/year in the cancer group and –0.04±0.77 mm/year in the benign group (P<0.01). The volume was significantly increased in the cancer group compared with the benign group (0.06±0.18 mL/year vs. 0.004±0.05 mL/year, respectively, P<0.01; 26.9%±57.9%/year vs. 1.7%±26.0%/year, P<0.01). Initial maximum diameter (β=0.02, P<0.01) and initial volume (β=0.13, P<0.01) were significantly associated with volume change (mL)/year. Initial maximum standardized uptake value did not predict the nodule growth.

Conclusion

It is suggested that thyroid cancer nodules progress rapidly compared with benign nodules. Initial size and volume of nodule were independent risk factors for cancer nodule growth.

Citations

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BMC Cancer.2019;[Epub] CrossRef

Special Article

Clinical Guidelines for the Management of Adrenal Incidentaloma: Jung-Min Lee, Mee Kyoung Kim, Seung-Hyun Ko, Jung-Min Koh, Bo-Yeon Kim, Sang Wan Kim, Soo-Kyung Kim, Hae Jin Kim, Ohk-Hyun Ryu, Juri Park, Jung Soo Lim, Seong Yeon Kim, Young Kee Shong, Soon Jib Yoo; Endocrinol Metab. 2017;32(2):200-218. Published online June 23, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.200

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An adrenal incidentaloma is an adrenal mass found in an imaging study performed for other reasons unrelated to adrenal disease and often accompanied by obesity, diabetes, or hypertension. The prevalence and incidence of adrenal incidentaloma increase with age and are also expected to rise due to the rapid development of imaging technology and frequent imaging studies. The Korean Endocrine Society is promoting an appropriate practice guideline to meet the rising incidence of adrenal incidentaloma, in cooperation with the Korean Adrenal Gland and Endocrine Hypertension Study Group. In this paper, we discuss important core issues in managing the patients with adrenal incidentaloma. After evaluating core proposition, we propose the most critical 20 recommendations from the initially organized 47 recommendations by Delphi technique.

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Letter

Letter: Comparison of Age of Onset and Frequency of Diabetic Complications in the Very Elderly Patients with Type 2 Diabetes (Endocrinol Metab 2016;31:416-23, Bong-Ki Lee et al.): Mee Kyoung Kim; Endocrinol Metab. 2017;32(1):140-141. Published online March 20, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.1.140

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Review Article

Obesity and Metabolism
2014 Clinical Practice Guidelines for Overweight and Obesity in Korea: Mee Kyoung Kim, Won-Young Lee, Jae-Heon Kang, Jee-Hyun Kang, Bom Taeck Kim, Seon Mee Kim, Eun Mi Kim, Sang-Hoon Suh, Hye Jung Shin, Kyu Rae Lee, Ki Young Lee, Sang Yeoup Lee, Seon Yeong Lee, Seong-Kyu Lee, Chang Beom Lee, Sochung Chung, In Kyung Jeong, Kyung Yul Hur, Sung Soo Kim, Jeong-taek Woo; Endocrinol Metab. 2014;29(4):405-409. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.405

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The dramatic increase in the prevalence of obesity and its accompanying comorbidities are major health concerns in Korea. Obesity is defined as a body mass index ≥25 kg/m² in Korea. Current estimates are that 32.8% of adults are obese: 36.1% of men and 29.7% of women. The prevalence of being overweight and obese in national surveys is increasing steadily. Early detection and the proper management of obesity are urgently needed. Weight loss of 5% to 10% is the standard goal. In obese patients, control of cardiovascular risk factors deserves the same emphasis as weight-loss therapy. Since obesity is multifactorial, proper care of obesity requires a coordinated multidisciplinary treatment team, as a single intervention is unlikely to modify the incidence or natural history of obesity.

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The Effect of Interaction between Obesity and Grip Strength on Health-Related Quality of Life in Elderly: Based on the Korea National Health and Nutrition Examination Survey (2016-2018)
Seungjae Hyun, Darae Woo, Sangshin Park
Journal of Health Informatics and Statistics.2021; 46(1): 28. CrossRef
Effects of a Lifestyle Intervention on Health-Promoting Behavior, Psychological Distress and Reproductive Health of Overweight and Obese Female College Students
Ju-Hee Nho, Soo-Wan Chae
Healthcare.2021; 9(3): 309. CrossRef
A Modular Mobile Health App for Personalized Rehabilitation Throughout the Breast Cancer Care Continuum: Development Study
Ji Young Lim, Jong Kwang Kim, Yoon Kim, So-Yeon Ahn, Jonghan Yu, Ji Hye Hwang
JMIR Formative Research.2021; 5(4): e23304. CrossRef
Sarcopenic Obesity Is Significantly Associated With Coronary Artery Calcification
Goh Eun Chung, Hyo Eun Park, Heesun Lee, Min Joo Kim, Su-Yeon Choi, Jeong Yoon Yim, Ji Won Yoon
Frontiers in Medicine.2021;[Epub] CrossRef
Practical Approaches to Treating Obesity: Patient and Healthcare Professional Perspectives
Donal O’Shea, Scott Kahan, Lorna Lennon, Cathy Breen
Advances in Therapy.2021; 38(7): 4138. CrossRef
Association between obesity and chronic rhinosinusitis with nasal polyps: a national population-based study
Jae-Sung Nam, Yun Ho Roh, Wasan Almazouq Fahad, Hae-Eun Noh, Jong-Gyun Ha, Joo-Heon Yoon, Chang-Hoon Kim, Hyung-Ju Cho
BMJ Open.2021; 11(5): e047230. CrossRef
Effect of pre-operative internal obturator muscle mass index in MRI on biochemical recurrence of prostate cancer patients after radical prostatectomy: a multi-center study
Won Tae Kim, Ho Won Kang, Sung Pil Seo, Yong-June Kim, Sang Cheol Lee, Wun-Jae Kim, Bum Sang Cho, Yun Sok Ha, Tae Gyun Kwon, Jinsung Park, Seung Chol Park, Young Beom Jeong, Taek Won Kang, Sung-Woo Park, Seok Joong Yun
BMC Urology.2021;[Epub] CrossRef
Clinical factors associated with reduced global longitudinal strain in subjects with normal left ventricular ejection fraction
Hack-Lyoung Kim, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Myung-A Kim, Joo-Hee Zo
The International Journal of Cardiovascular Imaging.2021; 37(11): 3225. CrossRef
Combined Effects of Unhealthy Lifestyle Behaviors on Metabolic Syndrome among Postmenopausal Women
Jin-Suk Ra, Hyesun Kim
Healthcare.2021; 9(7): 848. CrossRef
Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data
J. Ha, C. Jeong, K.-D. Han, Y. Lim, M.K. Kim, H.-S. Kwon, K.-H. Song, M.I. Kang, K.-H. Baek
Osteoporosis International.2021; 32(12): 2543. CrossRef
Evaluation of the association between periodontitis and risk of Parkinson’s disease: a nationwide retrospective cohort study
Eunkyung Jeong, Jun-Beom Park, Yong-Gyu Park
Scientific Reports.2021;[Epub] CrossRef
Combined Effects of Metabolic Abnormalities and Obesity on Cardiovascular Diseases among Korean Postmenopausal Women
Jin Suk Ra
Healthcare.2021; 9(8): 1064. CrossRef
Association of waist circumference with muscle and fat mass in adults with a normal body mass index
Gyeongsil Lee, Seulggie Choi, Sang Min Park
Nutrition Research and Practice.2021; 15(5): 604. CrossRef
Being Underweight Increases the Risk of Non-Cystic Fibrosis Bronchiectasis in the Young Population: A Nationwide Population-Based Study
Bumhee Yang, Kyungdo Han, Sang Hyuk Kim, Dong-Hwa Lee, Sang Hyun Park, Jung Eun Yoo, Dong Wook Shin, Hayoung Choi, Hyun Lee
Nutrients.2021; 13(9): 3206. CrossRef
Increased Risk of Chronic Kidney Disease Associated With Weight Gain in Healthy Adults: Insight From Metabolic Profiles and Body Composition
Hae-Ryong Yun, Hyung Woo Kim, Tae Ik Chang, Ea Wha Kang, Young Su Joo, Ki Heon Nam, Hyoungnae Kim, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han
Frontiers in Medicine.2021;[Epub] CrossRef
Risk Factors for Grade 3 to Grade 4 Adverse Reactions to the ChAdOx1 nCoV-19 Vaccine (AZD1222) Against SARS-CoV-2
Sang Won Lee, Hyun Lee, Sun-Kyung Lee, Ji-Yong Moon, SeolHwa Moon, Sung Jun Chung, Yoomi Yeo, Tai Sun Park, Dong Won Park, Tae-Hyung Kim, Jang Won Sohn, Ho Joo Yoon, Sang-Heon Kim
Frontiers in Medicine.2021;[Epub] CrossRef
Association between metabolic syndrome and incidence of ocular motor nerve palsy
Daye Diana Choi, Kyungdo Han, Sei Yeul Oh, Kyung-Ah Park
Scientific Reports.2021;[Epub] CrossRef
Anti-SARS-CoV-2 Spike Protein RBD Antibody Levels After Receiving a Second Dose of ChAdOx1 nCov-19 (AZD1222) Vaccine in Healthcare Workers: Lack of Association With Age, Sex, Obesity, and Adverse Reactions
Sang Won Lee, Ji-Yong Moon, Sun-Kyung Lee, Hyun Lee, SeolHwa Moon, Sung Jun Chung, Yoomi Yeo, Tai Sun Park, Dong Won Park, Tae-Hyung Kim, Jang Won Sohn, Ho Joo Yoon, Sang-Heon Kim
Frontiers in Immunology.2021;[Epub] CrossRef
Fatty Liver Index for Predicting Nonalcoholic Fatty Liver Disease in an Asymptomatic Korean Population
Eun-Ju Cho, Gu-Cheol Jung, Min-Sun Kwak, Jong-In Yang, Jeong-Yoon Yim, Su-Jong Yu, Goh-Eun Chung
Diagnostics.2021; 11(12): 2233. CrossRef
The Change in Metabolic Syndrome Status and the Risk of Nonviral Liver Cirrhosis
Goh-Eun Chung, Young Chang, Yuri Cho, Eun-Ju Cho, Jeong-Ju Yoo, Sang-Hyun Park, Kyungdo Han, Dong-Wook Shin, Su-Jong Yu, Yoon-Jun Kim, Jung-Hwan Yoon
Biomedicines.2021; 9(12): 1948. CrossRef
Weight change and resolution of fatty liver in normal weight individuals with nonalcoholic fatty liver disease
Dong Hyun Sinn, Danbee Kang, Soo Jin Cho, Seung Woon Paik, Eliseo Guallar, Juhee Cho, Geum-Youn Gwak
European Journal of Gastroenterology & Hepatology.2021; 33(1S): e529. CrossRef
Relationship between Metabolic Syndrome, Metabolic Syndrome Score, Insulin Resistance and Beta Cell Function in Korean Adults with Obesity
Hyun Yoon
The Korean Journal of Clinical Laboratory Science.2020; 52(4): 327. CrossRef
Alcoholic and Nonalcoholic Fatty Liver Disease and Incident Hospitalization for Liver and Cardiovascular Diseases
Yoosoo Chang, Juhee Cho, Yong Kyun Cho, Ara Cho, Yun Soo Hong, Di Zhao, Jiin Ahn, Chong Il Sohn, Hocheol Shin, Eliseo Guallar, Seungho Ryu
Clinical Gastroenterology and Hepatology.2020; 18(1): 205. CrossRef
Exercise training reduces inflammatory metabolic activity of visceral fat assessed by18F‐FDG PET/CT in obese women
Kisoo Pahk, Eung Ju Kim, Chanmin Joung, Hong Seog Seo, Sungeun Kim
Clinical Endocrinology.2020; 93(2): 127. CrossRef
Decrease in waist-to-hip ratio reduced the development of chronic kidney disease in non-obese non-alcoholic fatty liver disease
Young Eun Chon, Hyung Jong Kim, Yu Bum Choi, Seong Gyu Hwang, Kyu Sung Rim, Mi Na Kim, Joo Ho Lee, Yeonjung Ha, Mi Jung Lee
Scientific Reports.2020;[Epub] CrossRef
The number of metabolic features as a significant prognostic factor in patients with metastatic renal cell carcinoma
Hyeong Dong Yuk, Eu Chang Hwang, Jae Young Park, Chang Wook Jeong, Cheryn Song, Seong Il Seo, Seok-Soo Byun, Cheol Kwak, Sung-Hoo Hong, Minyong Kang, Jinsoo Chung, Hakmin Lee
Scientific Reports.2020;[Epub] CrossRef
Changes in Metabolic Syndrome Status and Risk of Dementia
Ji Eun Lee, Dong Wook Shin, Kyungdo Han, Dahye Kim, Jung Eun Yoo, Jinkook Lee, SangYun Kim, Ki Young Son, Belong Cho, Moon Jong Kim
Journal of Clinical Medicine.2020; 9(1): 122. CrossRef
Factors Associated with Metabolic Syndrome Among Middle-Aged Women in Their 50s: Based on National Health Screening Data
HyungSeon Kim, YeonHee Cho
International Journal of Environmental Research and Public Health.2020; 17(9): 3008. CrossRef
Weight Change and Development of Subclinical Carotid Atherosclerosis Among Metabolically Healthy Adults: A Cohort Study
Dong Hyun Sinn, Danbee Kang, Soo Jin Cho, Yoosoo Chang, Seungho Ryu, Young Bin Song, Seung Woon Paik, Yun Soo Hong, Di Zhao, Eliseo Guallar, Juhee Cho, Geum-Youn Gwak
The Journal of Clinical Endocrinology & Metabolism.2020; 105(3): e410. CrossRef
Serum gamma-glutamyltransferase activity and Parkinson’s disease risk in men and women
Dallah Yoo, Ryul Kim, Yu Jin Jung, Kyungdo Han, Cheol Min Shin, Jee-Young Lee
Scientific Reports.2020;[Epub] CrossRef
Impact of Mean and Variability of High‐Density Lipoprotein‐Cholesterol on the Risk of Myocardial Infarction, Stroke, and Mortality in the General Population
Byung‐Hun Han, Kyungdo Han, Kun‐Ho Yoon, Mee Kyoung Kim, Seung‐Hwan Lee
Journal of the American Heart Association.2020;[Epub] CrossRef
A model to predict risk of stroke in middle-aged adults with type 2 diabetes generated from a nationwide population-based cohort study in Korea
Mee-Kyoung Kim, Kyungdo Han, Jae-Hyoung Cho, Hyuk-Sang Kwon, Kun-Ho Yoon, Seung-Hwan Lee
Diabetes Research and Clinical Practice.2020; 163: 108157. CrossRef
Gamma-Glutamyl Transferase Variability and Risk of Dementia in Diabetes Mellitus: A Nationwide Population-Based Study
So-hyeon Hong, Kyungdo Han, Sanghyun Park, Seon Mee Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Yong Gyu Park, Hye Jin Yoo
The Journal of Clinical Endocrinology & Metabolism.2020; 105(3): e119. CrossRef
Subclinical thyroid dysfunction, bone mineral density, and osteoporosis in a middle-aged Korean population
K. Lee, S. Lim, H. Park, H.Y. Woo, Y. Chang, E. Sung, H.S. Jung, K.E. Yun, C.W. Kim, S. Ryu, M.J. Kwon
Osteoporosis International.2020; 31(3): 547. CrossRef
Effects of lorcaserin on cardiometabolic risk factors in overweight and obese patients: A systematic review and meta‐analysis
Hsiao‐Huai Kuo, Kuang‐Te Wang, Ying‐Hsiang Lee, Po‐Lin Lin, Ming‐En Liu, Chien‐Yu Lin, Lawrence Yu‐Min Liu
Journal of Clinical Pharmacy and Therapeutics.2020; 45(1): 35. CrossRef
Effect of mHealth With Offline Antiobesity Treatment in a Community-Based Weight Management Program: Cross-Sectional Study
Youngin Kim, Bumjo Oh, Hyun-Young Shin
JMIR mHealth and uHealth.2020; 8(1): e13273. CrossRef
Incidence of extrahepatic cancers among individuals with chronic hepatitis B or C virus infection: A nationwide cohort study
Chai Yeong Hong, Dong Hyun Sinn, Danbee Kang, Seung Woon Paik, Eliseo Guallar, Juhee Cho, Geum‐Youn Gwak
Journal of Viral Hepatitis.2020; 27(9): 896. CrossRef
The Impact of Body Mass Index on the Prognostic Value of N-Terminal proB-Type Natriuretic Peptide in Patients with Heart Failure: an Analysis from the Korean Heart Failure (KorHF) Registry
Hack-Lyoung Kim, Myung-A Kim, Sohee Oh, Dong-Ju Choi, Seongwoo Han, Eun-Seok Jeon, Myeong-Chan Cho, Jae-Joong Kim, Byung-Su Yoo, Mi-Seung Shin, Seok-Min Kang, Shung Chull Chae, Kyu-Hyung Ryu
International Journal of Heart Failure.2020; 2(1): 45. CrossRef
Characterization of Metabolic Syndrome Risk Factors and Health-Related Behaviors in Korean Patients With Breast Cancer by Abdominal Obesity Status
Hye-Jin KIM, Hee-Seung KIM, Hye-Ryoung KIM, Yang-Sook YOO, Byung Joo SONG
Journal of Nursing Research.2020; 28(2): e74. CrossRef
Antiadipogenic Effects of Mixtures of Cornus officinalis and Ribes fasciculatum Extracts on 3T3-L1 Preadipocytes and High-Fat Diet-Induced Mice
Eunkuk Park, Chang Gun Lee, Hyesoo Jeong, Subin Yeo, Ji Ae Kim, Seon-Yong Jeong
Molecules.2020; 25(10): 2350. CrossRef
Umbilical Port Site Hernia and Diastasis Recti
Hyun Jeong Ki, Jun Beom Park, Ji-Young Sul
The Journal of Minimally Invasive Surgery.2020; 23(2): 80. CrossRef
Risk of type 2 diabetes according to the cumulative exposure to metabolic syndrome or obesity: A nationwide population‐based study
You‐Bin Lee, Da Hye Kim, Seon Mee Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Yong Gyu Park, Kyungdo Han, Hye Jin Yoo
Journal of Diabetes Investigation.2020; 11(6): 1583. CrossRef
Hospitalization for heart failure incidence according to the transition in metabolic health and obesity status: a nationwide population-based study
You-Bin Lee, Da Hye Kim, Seon Mee Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Yong Gyu Park, Kyungdo Han, Hye Jin Yoo
Cardiovascular Diabetology.2020;[Epub] CrossRef
Effects of Gender and Age on Dietary Intake and Body Mass Index in Hypertensive Patients: Analysis of the Korea National Health and Nutrition Examination
Hyunju Dan, Jiyoung Kim, Oksoo Kim
International Journal of Environmental Research and Public Health.2020; 17(12): 4482. CrossRef
Peripartum Blood Transfusions are Associated with Increased Risk of Cancer: A National Retrospective Cohort Study

Geum Joon Cho, Michael S Oh, Min-Jeong Oh, Keon Vin Park, Sung Won Han, Young Kwang Chae
Clinical Epidemiology.2020; Volume 12: 659. CrossRef
Association of Body Mass Index with the Risk of Incident Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality: A Community-Based Prospective Study
Ji Cheol Bae, Nam H. Cho, Jae Hyeon Kim, Kyu Yeon Hur, Sang-Man Jin, Moon-Kyu Lee
Endocrinology and Metabolism.2020; 35(2): 416. CrossRef
Gamma-glutamyl transferase variability can predict the development of end-stage of renal disease: a nationwide population-based study
Da Young Lee, Kyungdo Han, Ji Hee Yu, Sanghyun Park, Jee-In Heo, Ji A. Seo, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Seon Mee Kim, Kyung Mook Choi, Sei Hyun Baik, Yong Gyu Park, Nan Hee Kim
Scientific Reports.2020;[Epub] CrossRef
Beneficial Effects of Breastfeeding on the Prevention of Metabolic Syndrome Among Postmenopausal Women
Jin Suk Ra, Soon Ok Kim
Asian Nursing Research.2020; 14(3): 173. CrossRef
Risk of hepatocellular carcinoma in individuals without traditional risk factors: development and validation of a novel risk score
Dong Hyun Sinn, Danbee Kang, Soo Jin Cho, Seung Woon Paik, Eliseo Guallar, Juhee Cho, Geum-Youn Gwak
International Journal of Epidemiology.2020; 49(5): 1562. CrossRef
Relationships between cognitive function and frailty in older Korean adults: The moderating effect of the number of teeth
Ji-hye Yun, Seung-kook Ki, Jinhee Kim, Doukyoung Chon, Seung-yun Shin, Yunhwan Lee
Archives of Gerontology and Geriatrics.2020; 91: 104213. CrossRef
The association between sleep and weight loss among adult women with obesity administered with Gamitaeeumjowee-tang
Eom-Jee Lee, Young-Bae Park, Young-Woo Lim, Seo-Young Kim
Journal of Korean Medicine.2020; 41(3): 22. CrossRef
Factors Associated with Dietary Control and Physical Activity in the Management of Metabolic Syndrome in Korean Menopausal Women
Guna Lee, Hye Young Choi
International Journal of Environmental Research and Public Health.2020; 17(18): 6901. CrossRef
The Prevalence of Metabolic Syndrome and Health-Related Behavior Changes: The Korea National Health Examination Survey
Eunshil Yim, Kyounga Lee, Ilsu Park, Sangjin Lee
Healthcare.2020; 8(2): 134. CrossRef
Pilot study: asymptomatic hyperuricemia patients with obesity and nonalcoholic fatty liver disease have increased risk of double contour sign
Hong Ki Min, Hyonjoung Cho, Sung-Hwan Park
The Korean Journal of Internal Medicine.2020; 35(6): 1517. CrossRef
Putative positive role of inflammatory genes in fat deposition supported by altered gene expression in purified human adipocytes and preadipocytes from lean and obese adipose tissues
Sang-Hyeop Lee, Nak-Hyeon Choi, In-Uk Koh, Bong-Jo Kim, Song Lee, Song-Cheol Kim, Sun Shim Choi
Journal of Translational Medicine.2020;[Epub] CrossRef
Efficacy and Safety of Combined Extracts of Cornus officinalis and Ribes fasciculatum for Body Fat Reduction in Overweight Women
Eunkuk Park, Chang Gun Lee, Jeonghyun Kim, Jae-Heon Kang, Young Gyu Cho, Seon-Yong Jeong
Journal of Clinical Medicine.2020; 9(11): 3629. CrossRef
The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis
Changsung Han, Heajin Chung, Youngjoo Lee, Hye Young Jang, Young Shin Cho, Junbum Park, Sang-Il Kim
Clinical and Experimental Emergency Medicine.2020; 7(4): 267. CrossRef
The Anti-obesity Effects of Bangpungtongseong-san and Daesiho-tang: A Study Protocol of Randomized, Double-blinded Clinical Trial
Jihong Oh, Hyeyoon Shim, Jiyun Cha, Ho Seok Kim, Min Ji Kim, Eun Kyung Ahn, Myeong-Jong Lee, Jun-Hwan Lee, Hojun Kim
Journal of Korean Medicine for Obesity Research.2020; 20(2): 138. CrossRef
Retinal Vein Occlusion is Associated with Low Blood High-Density Lipoprotein Cholesterol: A Nationwide Cohort Study
Jaeryung Kim, Dong Hui Lim, Kyungdo Han, Se Woong Kang, Don-Il Ham, Sang Jin Kim, Tae-Young Chung
American Journal of Ophthalmology.2019; 205: 35. CrossRef
Influence of the type of occupation on osteoarthritis of the knee in men: The Korean National Health and Nutrition Examination Survey 2010-2012
Sara Kwon, Won Kim, Seoyon Yang, Kyoung Hyo Choi
Journal of Occupational Health.2019; 61(1): 54. CrossRef
Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition
Dae Yong Yi, Soon Chul Kim, Ji Hyuk Lee, Eun Hye Lee, Jae Young Kim, Yong Joo Kim, Ki Soo Kang, Jeana Hong, Jung Ok Shim, Yoon Lee, Ben Kang, Yeoun Joo Lee, Mi Jin Kim, Jin Soo Moon, Hong Koh, JeongAe You, Young-Sook Kwak, Hyunjung Lim, Hye Ran Yang
Pediatric Gastroenterology, Hepatology & Nutrition.2019; 22(1): 1. CrossRef
2018 Korean Society for the Study of Obesity Guideline for the Management of Obesity in Korea
Mi Hae Seo, Won-Young Lee, Sung Soo Kim, Jae-Heon Kang, Jee-Hyun Kang, Kyoung Kon Kim, Bo-Yeon Kim, Yang-Hyun Kim, Won-Jun Kim, Eun Mi Kim, Hyun Soo Kim, Yun-A Shin, Hye-Jung Shin, Kyu Rae Lee, Ki Young Lee, Sang Yeoup Lee, Seong-Kyu Lee, Joo Ho Lee, Chan
Journal of Obesity & Metabolic Syndrome.2019; 28(1): 40. CrossRef
Research trends in obesity & obesogenic environments in Korea
Myoungsook Lee
Nutrition Research and Practice.2019; 13(6): 461. CrossRef
Maintenance of body weight is an important determinant for the risk of ischemic stroke: A nationwide population-based cohort study
Jung-Hwan Cho, Eun-Jung Rhee, Se Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Soon-Jib Yoo, Yang-Hyun Kim, Won-Young Lee, Sabine Rohrmann
PLOS ONE.2019; 14(1): e0210153. CrossRef
The Effects of Utilizing Smartphone Application Peer Support on Health Behavior and Body Mass Index among Breast Cancer Survivors
Gaeun Park, Haejung Lee, Hyun Yul Kim
Journal of Korean Academy of Nursing.2019; 49(5): 550. CrossRef
Non alcoholic fatty liver disease and risk of incident diabetes in subjects who are not obese
K.-C. Sung, D.-C. Seo, S.-J. Lee, M.-Y. Lee, S.H. Wild, C.D. Byrne
Nutrition, Metabolism and Cardiovascular Diseases.2019; 29(5): 489. CrossRef
Association between obesity type and obstructive coronary artery disease in stable symptomatic postmenopausal women: data from the KoRean wOmen'S chest pain rEgistry (KoROSE)
Jun Hwan Cho, Hack-Lyoung Kim, Myung-A Kim, Sohee Oh, Mina Kim, Seong Mi Park, Hyun Ju Yoon, Mi Seung Shin, Kyung-Soon Hong, Gil Ja Shin, Wan-Joo Shim
Menopause.2019; 26(11): 1272. CrossRef
Weight change is significantly associated with risk of thyroid cancer: A nationwide population-based cohort study
Hyemi Kwon, Kyung-Do Han, Cheol-Young Park
Scientific Reports.2019;[Epub] CrossRef
Effects of Multidisciplinary Lifestyle Modification Program on Health-promoting Behavior, Psychological Distress, Body Composition and Reproductive Symptoms among Overweight and Obese Middle-aged Women
Ju-Hee Nho, Eun Suk Hwang
Korean Journal of Adult Nursing.2019; 31(6): 663. CrossRef
Higher body mass index is not a protective risk factor for 28-days mortality in critically ill patients with acute kidney injury undergoing continuous renal replacement therapy
Hai Wang, Yu Shi, Zheng-Hai Bai, Jun-Hua Lv, Jiang-Li Sun, Hong-Hong Pei, Zheng-Liang Zhang
Renal Failure.2019; 41(1): 726. CrossRef
Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition
Dae Yong Yi, Soon Chul Kim, Ji Hyuk Lee, Eun Hye Lee, Jae Young Kim, Yong Joo Kim, Ki Soo Kang, Jeana Hong, Jung Ok Shim, Yoon Lee, Ben Kang, Yeoun Joo Lee, Mi Jin Kim, Jin Soo Moon, Hong Koh, JeongAe You, Young-Sook Kwak, Hyunjung Lim, Hye Ran Yang
Korean Journal of Pediatrics.2019; 62(1): 3. CrossRef
Frequency of Consumption of Whole Fruit, Not Fruit Juice, Is Associated with Reduced Prevalence of Obesity in Korean Adults
Ahreum Choi, Kyungho Ha, Hyojee Joung, YoonJu Song
Journal of the Academy of Nutrition and Dietetics.2019; 119(11): 1842. CrossRef
Effects of sarcopenia, body mass indices, and sarcopenic obesity on diastolic function and exercise capacity in Koreans
Mi-Hyang Jung, Sang-Hyun Ihm, Sang Min Park, Hae Ok Jung, Kyung-Soon Hong, Sang Hong Baek, Ho-Joong Youn
Metabolism.2019; 97: 18. CrossRef
Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India
Mohammad Mustufa Khan, Gyanendra Kumar Sonkar, Sangeeta Singh, Satyendra Kumar Sonkar
International Journal of Diabetes in Developing Countries.2019; 39(3): 419. CrossRef
Calorie Intake and Cognitive Function in the Elderly: Data from the Korean Frailty and Aging Cohort Study (KFACS)
J.-M. Park, J. Lee, Y. Kim, Chang Won Won, Youn-Jung Kim
The Journal of nutrition, health and aging.2019; 23(10): 930. CrossRef
Sex difference in IgE sensitization associated with alcohol consumption in the general population
Daeyoung Roh, Dong-Hee Lee, Sang-Kyu Lee, Soo Whan Kim, Sung Won Kim, Jin Hee Cho, Byung-Guk Kim, Ji-Hyeon Shin
Scientific Reports.2019;[Epub] CrossRef
Decline in lung function is associated with elevated lipoprotein (a) in individuals without clinically apparent disease: A cross‐sectional study
Jonghoo Lee, Hye Kyeong Park, Min‐Jung Kwon, Jae‐Uk Song
Respirology.2019; 24(1): 68. CrossRef
Relationship of rheumatoid arthritis and coronary artery disease in the Korean population: a nationwide cross-sectional study
Tae Hyub Lee, Gwan Gyu Song, Sung Jae Choi, Hongdeok Seok, Jae Hyun Jung
Advances in Rheumatology.2019;[Epub] CrossRef
Impact of Visceral Adipose Tissue on Clinical Outcomes After Acute Ischemic Stroke
Ja-Hae Kim, Kang-Ho Choi, Kyung-Wook Kang, Joon-Tae Kim, Seong-Min Choi, Seung-Han Lee, Man-Seok Park, Byeong C. Kim, Myeong-Kyu Kim, Ki-Hyun Cho
Stroke.2019; 50(2): 448. CrossRef
Efficacy and safety of Gelidium elegans intake on bowel symptoms in obese adults
Hyoung Il Choi, Jae Myung Cha, In-Kyung Jeong, In-Jin Cho, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Soo Jin Kim
Medicine.2019; 98(17): e14981. CrossRef
Increased risk of psoriasis in subjects with abdominal obesity: A nationwide population‐based study
Ju Hee Han, Ji Hyun Lee, Kyung Do Han, Ha‐Na Kim, Chul Hwan Bang, Young Min Park, Jun Young Lee, Tae Yoon Kim
The Journal of Dermatology.2019; 46(8): 695. CrossRef
The effect of low body mass index on the development of chronic obstructive pulmonary disease and mortality
H. J. Park, J. H. Cho, H. J. Kim, J.‐Y. Park, H. S. Lee, M. K. Byun
Journal of Internal Medicine.2019; 286(5): 573. CrossRef
Measuring Socioeconomic Inequalities in Obesity among Korean Adults, 1998–2015
Jongnam Hwang, Eun-Young Lee, Chung Gun Lee
International Journal of Environmental Research and Public Health.2019; 16(9): 1617. CrossRef
Association of leg muscle symmetry with knee osteoarthritis
Ji Yeon Lee, Kyungdo Han, Yong Gyu Park, Sung-Hwan Park
Clinical Rheumatology.2019; 38(12): 3549. CrossRef
Female urinary incontinence and obesity assessed by anthropometry and dual‐energy X‐ray absorptiometry: Analysis from the 2008–09 Korean National Health and Nutrition Examination Survey
Yeon Won Park, Jun Ho Lee
LUTS: Lower Urinary Tract Symptoms.2019;[Epub] CrossRef
Predictors of Assessment of Spondyloarthritis International Society (ASAS) Health Index in Axial Spondyloarthritis and Comparison of ASAS Health Index between Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Data from the Catholic Axial
Hong Ki Min, Jennifer Lee, Ji Hyeon Ju, Sung-Hwan Park, Seung-Ki Kwok
Journal of Clinical Medicine.2019; 8(4): 467. CrossRef
Sarcopenia Is Significantly Associated with Presence and Severity of Nonalcoholic Fatty Liver Disease
Goh Eun Chung, Min Joo Kim, Jeong Yoon Yim, Joo Sung Kim, Ji Won Yoon
Journal of Obesity & Metabolic Syndrome.2019; 28(2): 129. CrossRef
Metabolic Obesity Phenotypes and Thyroid Cancer Risk: A Cohort Study
Hyemi Kwon, Yoosoo Chang, Ara Cho, Jiin Ahn, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Hocheol Shin, Seungho Ryu, Eun-Jung Rhee
Thyroid.2019; 29(3): 349. CrossRef
Risk of end‐stage renal disease from chronic kidney disease defined by decreased glomerular filtration rate in type 1 diabetes: A comparison with type 2 diabetes and the effect of metabolic syndrome
You‐Bin Lee, Kyungdo Han, Bongsung Kim, Ji Eun Jun, Seung‐Eun Lee, Jiyeon Ahn, Gyuri Kim, Sang‐Man Jin, Jae Hyeon Kim
Diabetes/Metabolism Research and Reviews.2019;[Epub] CrossRef
Effect of physical activity on the cardiometabolic profiles of non-obese and obese subjects: Results from the Korea National Health and Nutritional Examination Survey
Sang Joon An, Mi-Hyang Jung, Sang-Hyun Ihm, Yun-jung Yang, Ho-Joong Youn, Ying-Mei Feng
PLOS ONE.2019; 14(3): e0208189. CrossRef
Colorectal Cancer Risks According to Sex Differences in Patients With Type II Diabetes Mellitus: A Korean Nationwide Population-Based Cohort Study
Ji Min Lee, Kang-Moon Lee, Dae Bum Kim, Seung-Hyun Ko, Yong Gyu Park
Clinical and Translational Gastroenterology.2019; 10(10): e00090. CrossRef
Risk of comorbid cardiovascular disease in Korean long‐term cancer survivors
Jinyoung Shin, Hyeonyoung Ko, Yoon‐Ho Choi, Inyoung Choi, Yun‐Mi Song
European Journal of Cancer Care.2019;[Epub] CrossRef
Variation in the TAS2R38 Bitterness Receptor Gene Was Associated with Food Consumption and Obesity Risk in Koreans
Jeong-Hwa Choi
Nutrients.2019; 11(9): 1973. CrossRef
Blood Pressure and Development of Cardiovascular Disease in Koreans With Type 2 Diabetes Mellitus
Mee Kyoung Kim, Kyungdo Han, Eun Sil Koh, Eun Sook Kim, Min-Kyung Lee, Ga Eun Nam, Hyuk-Sang Kwon
Hypertension.2019; 73(2): 319. CrossRef
Review on Acceptability of Patients towards Obesity Treatment Program
Eom-jee Lee, Seo-Young Kim, Young-Woo Lim, Young-Bae Park
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Original Article

Thyroid
Natural Course of Cytologically Benign Thyroid Nodules: Observation of Ultrasonographic Changes: Dong Jun Lim, Jee Young Kim, Ki Hyun Baek, Mee Kyoung Kim, Woo Chan Park, Jong Min Lee, Moo Il Kang, Bong Yun Cha; Endocrinol Metab. 2013;28(2):110-118. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.110

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Abstract PDF PubReader

Background

The natural course of cytologically benign thyroid nodules remains unclear. The aim of this study was to evaluate whether ultrasonographic (US) changes are associated with changes in nodule volume during follow-up.

Methods

We retrospectively reviewed over 4 years of clinical records of patients with benign thyroid nodules as confirmed by fine needle aspiration (FNA). In total, 186 patients with 202 benign thyroid nodules were included for study. We assessed for changes in nodule volume and examined the cystic portion of the nodule as well as four US features (echogenicity, margin, calcification pattern, and shape).

Results

During follow-up (mean, 21.7±10.7 months) and using 50% as a cutoff value, nodule volumes increased in 11.8%, exhibited no change in 79.9%, and decreased in 8.3% of patients. Proportion of nodules demonstrating at least one US change was 20.8% (42/202). The most common US changes (in descending order of frequency) were cystic change, margin change, and calcification pattern change. Nodule shape and echogenicity rarely changed. Increased nodule volume was not significantly associated with any US features or with the number of FNAs but was associated with younger age at time of diagnosis.

Conclusion

Although a portion of thyroid nodules confirmed as benign showed US changes or volume changes during the follow-up period, these findings may only represent the natural course of benign nodules. Frequent follow-up with US might be needed for only a small number of cases with suspicious US findings.

Citations

Citations to this article as recorded by

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Case Report

A Case of Graves' Disease Associated with Systemic Sclerosis.: Yune Jeong Lee, Mee Kyoung Kim, Dong Jun Lim, Ki Hoon Hur, Ki Hyun Baek, Moo Il Kang, Chul Soo Cho, Kwang Woo Lee, Gyeong Sin Park; J Korean Endocr Soc. 2007;22(3):220-224. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.220

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Abstract PDF

Systemic sclerosis is associated with a broad spectrum of autoimmune thyroid diseases. The association between systemic scleroderma and hypothyroidism is well established. However, there have been very few reports concerning the association between hyperthyroidism and systemic scleroderma. We experienced a patient with Graves' disease who presented with muscle weakness and the patient was finally diagnosed with systemic sclerosis via pathological examination of the muscle. We describe here a rare case of systemic sclerosis associated with Graves` disease.

Citations

Citations to this article as recorded by

Systemic Sclerosis Associated with Non-small Cell Lung Cancer and Papillary Thyroid Cancer: Case Report and Literature Review
Ho Jae Kim, Jung Joo Kim, Hee Jung Park, Yong Tai Kim
The Korean Journal of Medicine.2017; 92(3): 316. CrossRef

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