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14 "Sunghwan Suh"
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Review Article
Diabetes, obesity and metabolism
Glucocorticoid-Induced Hyperglycemia: A Neglected Problem
Jung-Hwan Cho, Sunghwan Suh
Endocrinol Metab. 2024;39(2):222-238.   Published online March 27, 2024
DOI: https://doi.org/10.3803/EnM.2024.1951
  • 6,505 View
  • 412 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDFPubReader   ePub   
Glucocorticoids provide a potent therapeutic response and are widely used to treat a variety of diseases, including coronavirus disease 2019 (COVID-19) infection. However, the issue of glucocorticoid-induced hyperglycemia (GIH), which is observed in over one-third of patients treated with glucocorticoids, is often neglected. To improve the clinical course and prognosis of diseases that necessitate glucocorticoid therapy, proper management of GIH is essential. The key pathophysiology of GIH includes systemic insulin resistance, which exacerbates hepatic steatosis and visceral obesity, as well as proteolysis and lipolysis of muscle and adipose tissue, coupled with β-cell dysfunction. For patients on glucocorticoid therapy, risk stratification should be conducted through a detailed baseline evaluation, and frequent glucose monitoring is recommended to detect the onset of GIH, particularly in high-risk individuals. Patients with confirmed GIH who require treatment should follow an insulin-centered regimen that varies depending on whether they are inpatients or outpatients, as well as the type and dosage of glucocorticoid used. The ideal strategy to maintain normoglycemia while preventing hypoglycemia is to combine basal-bolus insulin and correction doses with a continuous glucose monitoring system. This review focuses on the current understanding and latest evidence concerning GIH, incorporating insights gained from the COVID-19 pandemic.

Citations

Citations to this article as recorded by  
  • Effect of hypoglycemic events on cognitive function in individuals with type 2 diabetes mellitus: a dose–response meta-analysis
    Min Ye, Qiqi Yang, Lele Zhang, Hudie Song, Qin Fu, Jun Qian, Hongyu Xie, Aihong Yuan
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • Diabetes and the associated complications: The role of antioxidants in diabetes therapy and care
    Lowell Dilworth, Dewayne Stennett, Aldeam Facey, Felix Omoruyi, Shada Mohansingh, Felix O. Omoruyi
    Biomedicine & Pharmacotherapy.2024; 181: 117641.     CrossRef
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Editorial
Diabetes, obesity and metabolism
The Characteristics and Risk of Mortality in the Elderly Korean Population
Sunghwan Suh
Endocrinol Metab. 2023;38(5):522-524.   Published online October 23, 2023
DOI: https://doi.org/10.3803/EnM.2023.502
  • 1,434 View
  • 57 Download
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Original Articles
Diabetes, obesity and metabolism
Intake of Fruit and Glycemic Control in Korean Patients with Diabetes Mellitus Using the Korea National Health and Nutrition Examination Survey
Eunju Yoon, Ji Cheol Bae, Sunghwan Suh
Endocrinol Metab. 2023;38(5):538-544.   Published online August 8, 2023
DOI: https://doi.org/10.3803/EnM.2023.1730
  • 3,171 View
  • 138 Download
  • 1 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Despite the well-recognized health benefits of fresh fruit consumption, there is still substantial uncertainty about its potential effects on glycemic control in patients with type 2 diabetes mellitus (T2DM).
Methods
We examined the association of fresh fruit consumption and glycemic control in patients with T2DM using data from the 6th Korea National Health and Nutrition Examination Survey. The study sample was divided into three groups based on weekly fruit consumption frequency for the analysis.
Results
Patients with the highest fruit intake were older than those in the other two groups, and women were more likely to consume fruits in general. Being a current smoker and weekly alcohol intake also showed negative correlations according to the fruit intake tertiles. Fruit consumption was positively correlated with better hemoglobin A1c (HbA1c) levels. Moreover, patients in the highest tertile of fruit intake were 3.48 times more likely to be in good glycemic control defined as HbA1c <7%.
Conclusion
We observed that fruit consumption can be helpful in glycemic control in Korean patients with T2DM.

Citations

Citations to this article as recorded by  
  • The Relationship between Alcohol Consumption and Diabetes in Korean Adults
    Gi Tae Kim, Jae Woong Sull
    Biomedical Science Letters.2023; 29(3): 159.     CrossRef
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Diabetes, obesity and metabolism
Greater Severity of Steatosis Is Associated with a Higher Risk of Incident Diabetes: A Retrospective Longitudinal Study
Ji Min Han, Jung Hwan Cho, Hye In Kim, Sunghwan Suh, Yu-Ji Lee, Jung Won Lee, Kwang Min Kim, Ji Cheol Bae
Endocrinol Metab. 2023;38(4):418-425.   Published online July 12, 2023
DOI: https://doi.org/10.3803/EnM.2023.1729
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AbstractAbstract PDFPubReader   ePub   
Background
Fatty liver is associated with increased risk of developing type 2 diabetes. We aimed to evaluate whether the severity of hepatic steatosis is associated with incident diabetes.
Methods
We conducted a longitudinal analysis using data from 1,798 participants who underwent a comprehensive health checkup and abdominal computed tomography (CT). We assessed the association between baseline liver attenuation value on non-contrast CT images and risk of incident diabetes. All the participants were categorized into three groups based on the baseline liver attenuation value on non-contrast CT images: without hepatic steatosis (>57 Hounsfield unit [HU]), mild hepatic steatosis (41–57 HU), and moderate to severe hepatic steatosis (≤40 HU).
Results
During a median follow-up period of 5 years, 6.0% of the study participants progressed to diabetes. The incidence of diabetes was 17.3% in the moderate to severe hepatic steatosis group, 9.0% in the mild steatosis group, and 2.9% in those without hepatic steatosis. In a multivariate adjustment model, as compared with participants without hepatic steatosis, those with moderate to severe steatosis had a hazard ratio (HR) of 3.24 (95% confidence interval [CI], 1.64 to 4.2) for the development of diabetes, and those in the mild steatosis group had a HR of 2.33 (95% CI, 1.42 to 3.80). One standard deviation decrease in mean CT attenuation values of the liver was associated with a 40% increase in the development of diabetes (multivariate adjusted HR, 1.40; 95% CI, 1.2 to 1.63).
Conclusion
We found a positive association between severity of hepatic steatosis and risk of incident diabetes. Greater severity of steatosis was associated with a higher risk of incident diabetes.
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Corrigendum
Miscellaneous
Corrigendum: Affiliation Correction. Development and Validation of a Risk Scoring System Derived from Meta-Analyses for Papillary Thyroid Cancer
Sunghwan Suh, Tae Sik Goh, Yun Hak Kim, Sae-Ock Oh, Kyoungjune Pak, Ju Won Seok, In Joo Kim
Endocrinol Metab. 2023;38(2):287.   Published online April 27, 2023
DOI: https://doi.org/10.3803/EnM.2023.202
Corrects: Endocrinol Metab 2020;35(2):435
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Special Articles
Miscellaneous
Immune Checkpoint Inhibitors and Endocrine Disorders: A Position Statement from the Korean Endocrine Society
Hyemi Kwon, Eun Roh, Chang Ho Ahn, Hee Kyung Kim, Cheol Ryong Ku, Kyong Yeun Jung, Ju Hee Lee, Eun Heui Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Jun Sung Moon, Jin Hwa Kim, Mi-kyung Kim, The Committee of Clinical Practice Guideline of the Korean Endocrine Society
Endocrinol Metab. 2022;37(6):839-850.   Published online December 26, 2022
DOI: https://doi.org/10.3803/EnM.2022.1627
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  • 346 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
Immune checkpoint inhibitors (ICIs) including an anti-cytotoxic T-lymphocyte-associated antigen 4 inhibitor, anti-programmed cell death protein 1 (PD-1) inhibitors, and anti-PD-ligand 1 inhibitors are representative therapeutics for various malignancies. In oncology, the application of ICIs is currently expanding to a wider range of malignancies due to their remarkable clinical outcomes. ICIs target immune checkpoints which suppress the activity of T-cells that are specific for tumor antigens, thereby allowing tumor cells to escape the immune response. However, immune checkpoints also play a crucial role in preventing autoimmune reactions. Therefore, ICIs targeting immune checkpoints can trigger various immune-related adverse events (irAEs), especially in endocrine organs. Considering the endocrine organs that are frequently involved, irAEs associated endocrinopathies are frequently life-threatening and have unfavorable clinical implications for patients. However, there are very limited data from large clinical trials that would inform the development of clinical guidelines for patients with irAEs associated endocrinopathies. Considering the current clinical situation, in which the scope and scale of the application of ICIs are increasing, position statements from clinical specialists play an essential role in providing the appropriate recommendations based on both medical evidence and clinical experience. As endocrinologists, we would like to present precautions and recommendations for the management of immune-related endocrine disorders, especially those involving the adrenal, thyroid, and pituitary glands caused by ICIs.

Citations

Citations to this article as recorded by  
  • Patterns of hormonal changes in hypophysitis by immune checkpoint inhibitor
    Hyunji Sang, Yun Kyung Cho, Sang-hyeok Go, Hwa Jung Kim, Eun Hee Koh
    The Korean Journal of Internal Medicine.2024; 39(5): 801.     CrossRef
  • Pembrolizumab plus lenvatinib for radically unresectable or metastatic renal cell carcinoma in the Japanese population
    Ryo Fujiwara, Takeshi yuasa, kenichi kobayashi, tetsuya yoshida, susumu kageyama
    Expert Review of Anticancer Therapy.2023; 23(5): 461.     CrossRef
  • Incidence of Endocrine-Related Dysfunction in Patients Treated with New Immune Checkpoint Inhibitors: A Meta-Analysis and Comprehensive Review
    Won Sang Yoo, Eu Jeong Ku, Eun Kyung Lee, Hwa Young Ahn
    Endocrinology and Metabolism.2023; 38(6): 750.     CrossRef
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Miscellaneous
COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society
Cheol Ryong Ku, Kyong Yeun Jung, Chang Ho Ahn, Jun Sung Moon, Ju Hee Lee, Eun Heui Kim, Hyemi Kwon, Hee Kyung Kim, Sunghwan Suh, Sangmo Hong, Jeonghoon Ha, Eun Roh, Jin Hwa Kim, Mi-kyung Kim, the Committee of Clinical Practice Guideline of the Korean Endocrine Society
Endocrinol Metab. 2021;36(4):757-765.   Published online August 17, 2021
DOI: https://doi.org/10.3803/EnM.2021.404
  • 11,893 View
  • 427 Download
  • 20 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   ePub   
Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

Citations

Citations to this article as recorded by  
  • COVID-19 mRNA vaccine may trigger subacute thyroiditis
    Mehmet Sözen, Ömercan Topaloğlu, Berrin Çetinarslan, Alev Selek, Zeynep Cantürk, Emre Gezer, Damla Köksalan, Taner Bayraktaroğlu
    Human Vaccines & Immunotherapeutics.2024; 17(12): 5120.     CrossRef
  • The role of co-morbidities in the development of an AEFI after COVID-19 vaccination in a large prospective cohort with patient-reported outcomes in the Netherlands
    C. Ouaddouh, J.W. Duijster, T. Lieber, F.P.A.M. van Hunsel
    Expert Opinion on Drug Safety.2024; 23(3): 323.     CrossRef
  • Thyroid dysfunction in COVID-19
    David Tak Wai Lui, Chi Ho Lee, Yu Cho Woo, Ivan Fan Ngai Hung, Karen Siu Ling Lam
    Nature Reviews Endocrinology.2024; 20(6): 336.     CrossRef
  • Adult-Onset Type 1 Diabetes Development Following COVID-19 mRNA Vaccination
    Hyeyeon Moon, Sunghwan Suh, Mi Kyoung Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Prior immunization status of COVID-19 patients and disease severity: A multicenter retrospective cohort study assessing the different types of immunity
    Javaria Aslam, Faisal Shahzad Khan, Muhammad Talha Haris, Hewad Hewadmal, Maryam Khalid, Mohammad Y. Alshahrani, Qurrat-ul-ain Aslam, Irrum Aneela, Urooj Zafar
    Vaccine.2023; 41(2): 598.     CrossRef
  • Mortality and Severity of Coronavirus Disease 2019 in Patients with Long-Term Glucocorticoid Therapy: A Korean Nationwide Cohort Study
    Eu Jeong Ku, Keeho Song, Kyoung Min Kim, Gi Hyeon Seo, Soon Jib Yoo
    Endocrinology and Metabolism.2023; 38(2): 253.     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
  • Inactivated SARS-CoV-2 vaccination does not disturb the clinical course of Graves’ disease: An observational cohort study
    Shichen Xu, Huixin Yu, Xian Cheng, Jing Wu, Jiandong Bao, Li Zhang
    Vaccine.2023; 41(38): 5648.     CrossRef
  • Adrenal Crisis Associated With COVID-19 Vaccination in Patients With Adrenal Insufficiency
    Yukako Kurematsu, Takako Mohri, Sadanori Okada, Yutaka Takahashi
    JCEM Case Reports.2023;[Epub]     CrossRef
  • Adverse Events Associated with COVID-19 Vaccination in Adolescents with Endocrinological Disorders: A Cross-Sectional Study
    İbrahim Mert Erbaş, İrem Ceren Erbaş, Gözde Akın Kağızmanlı, Kübra Yüksek Acinikli, Özge Besci, Korcan Demir, Ece Böber, Nurşen Belet, Ayhan Abacı
    Journal of Clinical Research in Pediatric Endocrinology.2023; 15(3): 248.     CrossRef
  • Neue Aspekte der Glukokortikoidsubstitution bei Nebennierenrindeninsuffizienz
    Tina Kienitz, Gesine Meyer
    Der Internist.2022; 63(1): 12.     CrossRef
  • Endocrine Follow-up During Post-Acute COVID-19: Practical Recommendations Based on Available Clinical Evidence
    Rimesh Pal, Ameya Joshi, Sanjay K. Bhadada, Mainak Banerjee, Suresh Vaikkakara, Satinath Mukhopadhyay
    Endocrine Practice.2022; 28(4): 425.     CrossRef
  • Safety of Inactivated and mRNA COVID-19 Vaccination Among Patients Treated for Hypothyroidism: A Population-Based Cohort Study
    Xi Xiong, Carlos King Ho Wong, Ivan Chi Ho Au, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Celine Sze Ling Chui, Esther Wai Yin Chan, Franco Wing Tak Cheng, Kristy Tsz Kwan Lau, Chi Ho Lee, Yu Cho Woo, David Tak Wai Lui, Ian Chi Kei Wong
    Thyroid.2022; 32(5): 505.     CrossRef
  • The New Entity of Subacute Thyroiditis amid the COVID-19 Pandemic: From Infection to Vaccine
    Mihaela Popescu, Adina Ghemigian, Corina Maria Vasile, Andrei Costache, Mara Carsote, Alice Elena Ghenea
    Diagnostics.2022; 12(4): 960.     CrossRef
  • Adrenal Crisis Secondary to COVID-19 Vaccination in a Patient With Hypopituitarism
    Nikolina Markovic, Anila Faizan, Chirag Boradia, Sridhar Nambi
    AACE Clinical Case Reports.2022; 8(4): 171.     CrossRef
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    LingHong Huang, ZhengRong Jiang, JingXiong Zhou, YuPing Chen, HuiBin Huang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Osteoporosis in Patients With Respiratory Diseases
    Yue Ma, Shui Qiu, Renyi Zhou
    Frontiers in Physiology.2022;[Epub]     CrossRef
  • Pilot Findings on SARS-CoV-2 Vaccine-Induced Pituitary Diseases: A Mini Review from Diagnosis to Pathophysiology
    Ach Taieb, El Euch Mounira
    Vaccines.2022; 10(12): 2004.     CrossRef
  • Forty Years Together, New Leap Forward! The 40th Anniversary of the Korean Endocrine Society
    Jong Chul Won, Ki-Hyun Baek
    Endocrinology and Metabolism.2022; 37(6): 851.     CrossRef
  • No need of glucocorticoid dose adjustment in patients with adrenal insufficiency before COVID-19 vaccine
    Tania Pilli, Cristina Dalmiglio, Gilda Dalmazio, Alfonso Sagnella, Raffaella Forleo, Lucia Brilli, Fabio Maino, Cristina Ciuoli, Maria Grazia Castagna
    European Journal of Endocrinology.2022; 187(1): K7.     CrossRef
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    Hae Dong Choi, Jun Sung Moon
    The Journal of Korean Diabetes.2021; 22(4): 221.     CrossRef
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Original Article
Clinical Study
Development and Validation of a Risk Scoring System Derived from Meta-Analyses of Papillary Thyroid Cancer
Sunghwan Suh, Tae Sik Goh, Yun Hak Kim, Sae-Ock Oh, Kyoungjune Pak, Ju Won Seok, In Joo Kim
Endocrinol Metab. 2020;35(2):435-442.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.435
Correction in: Endocrinol Metab 2023;38(2):287
  • 6,287 View
  • 137 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The aim of this study was to develop a scoring system to stratify the risk of papillary thyroid cancer (PTC) and to select the proper management.
Methods
We performed a systematic search of MEDLINE and Embase. Data regarding patients’ prognoses were obtained from the included studies. Odds ratios (ORs) with statistical significance were extracted from the publications. To generate a risk scoring system (RSS), ORs were summed (RSS1), and summed after natural-logarithmic transformation (RSS2). RSS1 and RSS2 were compared to the eighth edition of the American Joint Committee on Cancer (AJCC) staging system and the 2015 American Thyroid Association (ATA) guidelines for thyroid nodules and differentiated thyroid carcinoma.
Results
Five meta-analyses were eligible for inclusion in the study. Eight variables (sex, tumour size, extrathyroidal extension, BRAF mutation, TERT mutation, histologic subtype, lymph node metastasis, and distant metastasis) were included. RSS1 was the best of the analysed models.
Conclusion
We developed and validated a new RSS derived from previous meta-analyses for patients with PTC. This RSS seems to be superior to previously published systems.

Citations

Citations to this article as recorded by  
  • Comparative Uptake Patterns of Radioactive Iodine and [18F]-Fluorodeoxyglucose (FDG) in Metastatic Differentiated Thyroid Cancers
    Devan Diwanji, Emmanuel Carrodeguas, Youngho Seo, Hyunseok Kang, Myat Han Soe, Janet M. Chiang, Li Zhang, Chienying Liu, Spencer C. Behr, Robert R. Flavell
    Journal of Clinical Medicine.2024; 13(13): 3963.     CrossRef
  • Investigating 18F-FDG PET/CT Parameters as Prognostic Markers for Differentiated Thyroid Cancer: A Systematic Review
    Hongxi Wang, Hongyuan Dai, Qianrui Li, Guohua Shen, Lei Shi, Rong Tian
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
    Joohyun Woo, Hyeonkyeong Kim, Hyungju Kwon
    Journal of Clinical Medicine.2021; 10(21): 5144.     CrossRef
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Review Article
Glucocorticoid-Induced Diabetes Mellitus: An Important but Overlooked Problem
Sunghwan Suh, Mi Kyoung Park
Endocrinol Metab. 2017;32(2):180-189.   Published online May 29, 2017
DOI: https://doi.org/10.3803/EnM.2017.32.2.180
  • 19,169 View
  • 711 Download
  • 120 Web of Science
  • 129 Crossref
AbstractAbstract PDFPubReader   ePub   

Glucocorticoids are widely used as potent anti-inflammatory and immunosuppressive drugs to treat a wide range of diseases. However, they are also associated with a number of side effects, including new-onset hyperglycemia in patients without a history of diabetes mellitus (DM) or severely uncontrolled hyperglycemia in patients with known DM. Glucocorticoid-induced diabetes mellitus (GIDM) is a common and potentially harmful problem in clinical practice, affecting almost all medical specialties, but is often difficult to detect in clinical settings. However, scientific evidence is lacking regarding the effects of GIDM, as well as strategies for prevention and treatment. Similarly to nonsteroid-related DM, the principles of early detection and risk factor modification apply. Screening for GIDM should be considered in all patients treated with medium to high doses of glucocorticoids. Challenges in the management of GIDM stem from wide fluctuations in postprandial hyperglycemia and the lack of clearly defined treatment protocols. Together with lifestyle measures, hypoglycemic drugs with insulin-sensitizing effects are indicated. However, insulin therapy is often unavoidable, to the point that insulin can be considered the drug of choice. The treatment of GIDM should take into account the degree and pattern of hyperglycemia, as well as the type, dose, and schedule of glucocorticoid used. Moreover, it is essential to instruct the patient and/or the patient's family about how to perform the necessary adjustments. Prospective studies are needed to answer the remaining questions regarding GIDM.

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    Lu Hao, Jisu Xue
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
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    Novia Ariani Dewi, Arina Titami
    Jurnal Farmasi SYIFA.2024; 2(2): 68.     CrossRef
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    Konstantinos Kitsios, Christina‐Maria Trakatelli
    Practical Diabetes.2024; 41(3): 27.     CrossRef
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Close layer
Original Article
Clinical Study
Glucose-Dependent Insulinotropic Peptide Level Is Associated with the Development of Type 2 Diabetes Mellitus
Sunghwan Suh, Mi Yeon Kim, Soo Kyoung Kim, Kyu Yeon Hur, Mi Kyoung Park, Duk Kyu Kim, Nam H. Cho, Moon-Kyu Lee
Endocrinol Metab. 2016;31(1):134-141.   Published online March 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.1.134
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AbstractAbstract PDFPubReader   
Background

Incretin hormone levels as a predictor of type 2 diabetes mellitus have not been fully investigated. Therefore, we measured incretin hormone levels to examine the relationship between circulating incretin hormones, diabetes, and future diabetes development in this study.

Methods

A nested case-control study was conducted in a Korean cohort. The study included the following two groups: the control group (n=149), the incident diabetes group (n=65). Fasting total glucagon-like peptide-1 (GLP-1) and total glucose-dependent insulinotropic peptide (GIP) levels were measured and compared between these groups.

Results

Fasting total GIP levels were higher in the incident diabetes group than in the control group (32.64±22.68 pmol/L vs. 25.54±18.37 pmol/L, P=0.034). There was no statistically significant difference in fasting total GLP-1 levels between groups (1.14±1.43 pmol/L vs. 1.39±2.13 pmol/L, P=0.199). In multivariate analysis, fasting total GIP levels were associated with an increased risk of diabetes (odds ratio, 1.005; P=0.012) independent of other risk factors.

Conclusion

Fasting total GIP levels may be a risk factor for the development of type 2 diabetes mellitus. This association persisted even after adjusting for other metabolic parameters such as elevated fasting glucose, hemoglobin A1c, and obesity in the pre-diabetic period.

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Close layer
Review Article
Thyroid
Subclinical Hypothyroidism and Cardiovascular Disease
Sunghwan Suh, Duk Kyu Kim
Endocrinol Metab. 2015;30(3):246-251.   Published online August 4, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.3.246
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AbstractAbstract PDFPubReader   

Subclinical hypothyroidism (SCH) is a common disorder that is characterized by elevated thyroid-stimulating hormone levels in conjunction with free thyroxine concentrations within the normal reference range. Thyroid hormones are known to affect the heart and vasculature and, as a result, the impact of SCH on the cardiovascular (CV) system has recently become an important topic of research. Strong evidence points to a link between SCH and CV risk factors such as alterations in blood pressure, lipid levels, and atherosclerosis. Additionally, accumulating evidence indicates that SCH is associated with metabolic syndrome and heart failure. The present review proposes that SCH may be a potentially modifiable risk factor of CV disease and mortality. However, large-scale clinical trials with appropriate power investigating the risks and benefits of SCH treatment are required to determine whether these benefits can be achieved with levothyroxine therapy.

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Close layer
Editorial
Obesity and Metabolism
Metformin-Associated Lactic Acidosis
Sunghwan Suh
Endocrinol Metab. 2015;30(1):45-46.   Published online March 27, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.1.45
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PDFPubReader   

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Close layer
Original Articles
Obesity and Metabolism
Sex Factors in the Metabolic Syndrome as a Predictor of Cardiovascular Disease
Sunghwan Suh, Jongha Baek, Ji Cheol Bae, Kyoung-Nyoun Kim, Mi Kyoung Park, Duk Kyu Kim, Nam H. Cho, Moon-Kyu Lee
Endocrinol Metab. 2014;29(4):522-529.   Published online December 29, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.4.522
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AbstractAbstract PDFPubReader   
Background

Metabolic syndrome (MetS) is a condition characterized by a cluster of metabolic disorders and is associated with increased risk of cardiovascular disease (CVD). This study analyzed data from the Korean Health and Genome Study to examine the impact of MetS on CVD.

Methods

A total of 8,898 subjects (4,241 males and 4,657 females), 40 to 69 years of age, were enrolled and evaluated for the development of new onset CVD from 2001 to 2012 (median 8.1 years of follow-up).

Results

The prevalence of MetS at baseline was 22.0% (932/4,241) and 29.7% (1,383/4,657) in males and females, respectively. MetS was associated with increased risk of coronary heart disease (CHD; hazard ratio [HR], 1.818; 95% confidence interval [CI], 1.312 to 2.520 in males; HR, 1.789; 95% CI, 1.332 to 2.404 in females) and CVD (HR, 1.689; 95% CI, 1.295 to 2.204 in males; HR, 1.686; 95% CI, 1.007 to 2.192 in females). Specifically, MetS was associated with risk of future stroke in females only (HR, 1.486; 95% CI, 1.007 to 2.192). Among MetS components, abdominal obesity and hypertension were independent predictors of both CHD and CVD. In addition, a higher number of MetS components correlated with higher CVD risk.

Conclusion

MetS is a significant risk factor for the development of CVD although its impact varies between sexes.

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Adrenal gland
Clinical Characteristics, Management, and Outcome of 22 Cases of Primary Hypophysitis
Sun Mi Park, Ji Cheol Bae, Ji Young Joung, Yoon Young Cho, Tae Hun Kim, Sang-Man Jin, Sunghwan Suh, Kyu Yeon Hur, Kwang-Won Kim
Endocrinol Metab. 2014;29(4):470-478.   Published online December 29, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.4.470
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AbstractAbstract PDFPubReader   
Background

Primary hypophysitis causes varying degrees of endocrine dysfunction and mass effect. The natural course and best treatment have not been well established.

Methods

Medical records of 22 patients who had been diagnosed with primary hypophysitis between January 2001 and March 2013 were retrospectively reviewed. Based on the anatomical location, we classified the cases as adenohypophysitis (AH), infundibuloneurohypophysitis (INH), and panhypophysitis (PH). Clinical presentation, endocrine function, pathologic findings, magnetic resonance imaging findings, and treatment courses were reviewed.

Results

Among 22 patients with primary hypophysitis, 81.8% (18/22) had involvement of the posterior pituitary lobe. Two patients of the AH (2/3, 66.6%) and three patients of the PH (3/10, 30%) groups initially underwent surgical mass reduction. Five patients, including three of the PH (3/10, 33.3%) group and one from each of the AH (1/3, 33.3%) and INH (1/9, 11.1%) groups, initially received high-dose glucocorticoid treatment. Nearly all of the patients treated with surgery or high-dose steroid treatment (9/11, 82%) required continuous hormone replacement during the follow-up period. Twelve patients received no treatment for mass reduction due to the absence of acute symptoms and signs related to a compressive mass effect. Most of them (11/12, 92%) did not show disease progression, and three patients recovered partially from hormone deficiency.

Conclusion

Deficits of the posterior pituitary were the most common features in our cases of primary hypophysitis. Pituitary endocrine defects responded less favorably to glucocorticoid treatment and surgery. In the absence of symptoms related to mass effect and with the mild defect of endocrine function, it may not require treatment to reduce mass except hormone replacement.

Citations

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