Endocrinology and Metabolism

Original Articles

Diabetes, obesity and metabolism
Alterations in Adipose Tissue and Adipokines in Heterozygous APE1/Ref-1 Deficient Mice: Eun-Ok Lee, Hao Jin, Sungmin Kim, Hee Kyoung Joo, Yu Ran Lee, Soo Yeon An, Shuyu Piao, Kwon Ho Lee, Byeong Hwa Jeon; Endocrinol Metab. 2024;39(6):932-945. Published online November 20, 2024; DOI: https://doi.org/10.3803/EnM.2024.2061

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Abstract PDF Supplementary Material PubReader ePub: Background
The role of apurinic/apyrimidinic endonuclease 1/redox factor-1 (APE1/Ref-1) in adipose tissue remains poorly understood. This study investigates adipose tissue dysfunction in heterozygous APE1/Ref-1 deficiency (APE1/Ref-1^+/-) mice, focusing on changes in adipocyte physiology, oxidative stress, adipokine regulation, and adipose tissue distribution.
Methods
APE1/Ref-1 mRNA and protein levels in white adipose tissue (WAT) were measured in APE1/Ref-1^+/- mice, compared to their wild-type (APE1/Ref-1+/+) controls. Oxidative stress was assessed by evaluating reactive oxygen species (ROS) levels. Histological and immunohistochemical analyses were conducted to observe adipocyte size and macrophage infiltration of WAT. Adipokine expression was measured, and micro-magnetic resonance imaging (MRI) was used to quantify abdominal fat volumes.
Results
APE1/Ref-1^+/- mice exhibited significant reductions in APE1/Ref-1 mRNA and protein levels in WAT and liver tissue. These mice also showed elevated ROS levels, suggesting a regulatory role for APE1/Ref-1 in oxidative stress in WAT and liver. Histological and immunohistochemical analyses revealed hypertrophic adipocytes and macrophage infiltration in WAT, while Oil Red O staining demonstrated enhanced ectopic fat deposition in the liver of APE1/Ref-1^+/- mice. These mice also displayed altered adipokine expression, with decreased adiponectin and increased leptin levels in the WAT, along with corresponding alterations in plasma levels. Despite no significant changes in overall body weight, microMRI assessments demonstrated a significant increase in visceral and subcutaneous abdominal fat volumes in APE1/Ref-1^+/- mice.
Conclusion
APE1/Ref-1 is crucial in adipokine regulation and mitigating oxidative stress. These findings suggest its involvement in adipose tissue dysfunction, highlighting its potential impact on abdominal fat distribution and its implications for obesity and oxidative stress-related conditions.

Diabetes, Obesity and Metabolism Big Data Articles (National Health Insurance Service Database)
Cardiovascular Outcomes of Obesity According to Menopausal Status: A Nationwide Population-Based Study: Bo Kyung Koo, Sang-Hyun Park, Kyungdo Han, Min Kyong Moon; Endocrinol Metab. 2021;36(5):1029-1041. Published online October 21, 2021; DOI: https://doi.org/10.3803/EnM.2021.1197

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Background
We estimated the effect of obesity on the incidence of cardiovascular disease (CVD) and mortality in women according to menopausal status.
Methods
Women aged 40 to 69 years under routine health check-ups provided by the National Health Insurance Service in 2009 were followed up till 2018 (n=2,208,559).
Results
In premenopausal women, a significant increment of mortality rate was found in underweight and obesity class II (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.31 to 1.67; and HR, 1.25; 95% CI, 1.12 to 1.39) compared to normal body mass index (BMI); overweight and obesity class I did not affect mortality rate. In postmenopausal women, obesity as well as overweight status reduced the risk of mortality compared to normal BMI (HR, 0.86; 95% CI, 0.83 to 0.88; and HR, 0.84; 95% CI, 0.82 to 0.86). By contrast, there was a linear association between CVD and BMI above the normal range irrespective of menopausal status, which was attenuated in diabetic women.
Conclusion
The current study replicated the J-shaped relationship between BMI and mortality, being more prominent in the postmenopausal group. The risk of CVD was linearly increased as BMI was increased above the normal range irrespective of menopausal status.

Citations

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A link between smoking behaviors and the risk of hidradenitis suppurativa in diabetic patients
Hwa Jung Yook, Esther Kim, Yeong Ho Kim, Gyu-Na Lee, Kyungdo Han, Ji Hyun Lee, Emanuele Scala
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Biosocial predictors and blood pressure goal attainment among postmenopausal women with hypertension
Geetha Kandasamy, Thangamani Subramani, Gigi Sam, Mona Almanasef, Tahani Almeleebia, Eman Shorog, Asma M. Alshahrani, Amjad Hmlan, Atheer Y. Al Suhaym, Kousalya Prabahar, Vinoth Prabhu Veeramani, Palanisamy Amirthalingam
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A nationwide cohort study on diabetes severity and risk of Parkinson disease
Kyungdo Han, Bongsung Kim, Seung Hwan Lee, Mee Kyoung Kim
npj Parkinson's Disease.2023;[Epub] CrossRef
Cardiovascular Outcomes according to Comorbidities and Low-Density Lipoprotein Cholesterol in Korean People with Type 2 Diabetes Mellitus
Min Kyong Moon, Junghyun Noh, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong
Diabetes & Metabolism Journal.2023; 47(1): 45. CrossRef
The effect of menopause on cardiovascular risk factors according to body mass index in middle-aged Korean women
Do Kyeong Song, Young Sun Hong, Yeon-Ah Sung, Hyejin Lee, Aysha Almas
PLOS ONE.2023; 18(3): e0283393. CrossRef
Low‐quality muscle mass rather than normal‐quality muscle mass determines fibrosis progression in biopsy‐proven NAFLD
Yun Kyu Lee, Bo Kyung Koo, Sae Kyung Joo, Dong Hyeon Lee, Heejoon Jang, Jee Won Chai, Myoung Seok Lee, Si Won Jang, Young Ho So, Jeong Hwan Park, Mee Soo Chang, Won Kim
Alimentary Pharmacology & Therapeutics.2023; 58(3): 322. CrossRef
Diabetes severity is strongly associated with the risk of active tuberculosis in people with type 2 diabetes: a nationwide cohort study with a 6-year follow-up
Ji Young Kang, Kyungdo Han, Seung-Hwan Lee, Mee Kyoung Kim
Respiratory Research.2023;[Epub] CrossRef
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
Non-pharmacologic treatment for obesity
Bo Kyung Koo
Journal of the Korean Medical Association.2022; 65(7): 400. CrossRef

Diabetes, Obesity and Metabolism
Lower High-Density Lipoprotein Cholesterol Concentration Is Independently Associated with Greater Future Accumulation of Intra-Abdominal Fat: Sun Ok Song, You-Cheol Hwang, Han Uk Ryu, Steven E. Kahn, Donna L. Leonetti, Wilfred Y. Fujimoto, Edward J. Boyko; Endocrinol Metab. 2021;36(4):835-844. Published online August 27, 2021; DOI: https://doi.org/10.3803/EnM.2021.1130

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Background
Both intra-abdominal fat (IAF) and high-density lipoprotein cholesterol (HDL-C) are known to be associated with cardiometabolic health. We evaluated whether the accumulation of computed tomography (CT)-measured IAF over 5 years was related to baseline HDL-C concentration in a prospective cohort study.
Methods
All participants were Japanese-Americans between the ages of 34 and 74 years. Plasma HDL-C concentration and CT measurements of IAF, abdominal subcutaneous fat (SCF), and thigh SCF cross-sectional areas were assessed at baseline and at 5-year follow-up visits.
Results
A total of 397 subjects without diabetes were included. The mean±standard deviation HDL-C concentration was 51.6±13.0 mg/dL in men and 66.0±17.0 mg/dL in women, and the IAF was 91.9±48.4 cm² in men and 63.1±39.5 cm² in women. The baseline plasma concentration of HDL-C was inversely associated with the change in IAF over 5 years using multivariable regression analysis with adjustment for age, sex, family history of diabetes, weight change over 5 years, and baseline measurements of body mass index, IAF, abdominal SCF, abdominal circumference, thigh SCF, and homeostatic model assessment for insulin resistance.
Conclusion
These results demonstrate that HDL-C concentration significantly predicts future accumulation of IAF over 5 years independent of age, sex, insulin sensitivity, and body composition in Japanese-American men and women without diabetes.

Citations

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Visceral Fat Area and Subcutaneous Fat Area Increase in Hyperthyroidism Patients After Treatment—A Single-Group Repeated-Measures Trial
Mengnan Li, Xifeng Yang, Ru Li, Baofeng Wu, Jinxuan Hao, Yijie Qi, Tao Bai, Luyang Yang, Yi Zhang, Yunfeng Liu
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 2165. CrossRef
Subcutaneous Fat Thickness with HDL and LDL Levels in Overweight Female Student
Amilia Yuni Damayanti, Fatimah Fatimah, Lulu’ Luthfiya, Afina Deni Kusumadiastuti
Amerta Nutrition.2023; 7(2SP): 13. CrossRef
Fenofibrate add-on to statin treatment is associated with low all-cause death and cardiovascular disease in the general population with high triglyceride levels
Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
Metabolism.2022; 137: 155327. CrossRef
The associations between lipid profiles and visceral obesity among gastrointestinal cancer patients: a cross-sectional study
Bo Gao, Xiangrui Li, Wenqing Chen, Shu’an Wang, Jian He, Yu Liu, Chao Ding, Xiaotian Chen
Lipids in Health and Disease.2022;[Epub] CrossRef

Diabetes, Obesity and Metabolism
Differences in Abdominal Body Composition According to Glycemic Status: An Inverse Probability Treatment Weighting Analysis: Seungbong Han, Young-Jee Jeon, Gyung-Min Park, Tae Young Lee, Soon Eun Park, Gyeongseok Yu, Byung Ju Kang; Endocrinol Metab. 2021;36(4):855-864. Published online August 11, 2021; DOI: https://doi.org/10.3803/EnM.2021.1086

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Background
Several studies have reported that abdominal fat and muscle changes occur in diabetic patients. However, there are few studies about such changes among prediabetic patients. In this study, we evaluated the differences in abdominal fat and muscles based on abdominopelvic computed tomography in prediabetic and diabetic subjects compared to normal subjects.
Methods
We performed a cross-sectional study using health examination data from March 2014 to June 2019 at Ulsan University Hospital and classified subjects into normal, prediabetic, and diabetic groups. We analyzed the body mass index corrected area of intra-abdominal components among the three groups using inverse probability treatment weighting (IPTW) analysis.
Results
Overall, 8,030 subjects were enrolled; 5,137 (64.0%), 2,364 (29.4%), and 529 (6.6%) subjects were included in the normal, prediabetic, and diabetic groups, respectively. After IPTW adjustment of baseline characteristics, there were significant differences in log visceral adipose tissue index (VATI; 1.22±0.64 cm²/[kg/m²] vs. 1.30±0.63 cm²/[kg/m²] vs. 1.47±0.64 cm²/[kg/m²], P<0.001) and low-attenuation muscle index (LAMI; 1.02±0.36 cm²/[kg/m²] vs. 1.03±0.36 cm²/[kg/m²] vs. 1.09±0.36 cm²/[kg/m²], P<0.001) among the normal, prediabetic, and diabetic groups. Prediabetic subjects had higher log VATI (estimated coefficient= 0.082, P<0.001), and diabetic subjects had higher log VATI (estimated coefficient=0.248, P<0.001) and LAMI (estimated coefficient=0.078, P<0.001) compared to normal subjects.
Conclusion
Considering that VATI and LAMI represented visceral fat and lipid-rich skeletal muscle volumes, respectively, visceral obesity was identified in both prediabetic and diabetic subjects compared to normal subjects in this study. However, intra-muscular fat infiltration was observed in diabetic subjects only.

Citations

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Quantitative CT histogram indices for abdominal muscles are associated with coronary artery disease severity
G. Geng, Z. Li, T. Yuan, G.-M. Quan
Clinical Radiology.2025; 83: 106840. CrossRef
Testosterone is associated with abdominal body composition derived from computed tomography: a large cross sectional study
Seungbong Han, Young-Jee Jeon, Tae Young Lee, Gyung-Min Park, Sungchan Park, Seong Cheol Kim
Scientific Reports.2022;[Epub] CrossRef

Diabetes, Obesity and Metabolism
Expression of LONP1 Is High in Visceral Adipose Tissue in Obesity, and Is Associated with Glucose and Lipid Metabolism: Ju Hee Lee, Saet-Byel Jung, Seong Eun Lee, Ji Eun Kim, Jung Tae Kim, Yea Eun Kang, Seul Gi Kang, Hyon-Seung Yi, Young Bok Ko, Ki Hwan Lee, Bon Jeong Ku, Minho Shong, Hyun Jin Kim; Endocrinol Metab. 2021;36(3):661-671. Published online June 22, 2021; DOI: https://doi.org/10.3803/EnM.2021.1023

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Background
The nature and role of the mitochondrial stress response in adipose tissue in relation to obesity are not yet known. To determine whether the mitochondrial unfolded protein response (UPR^mt) in adipose tissue is associated with obesity in humans and rodents.
Methods
Visceral adipose tissue (VAT) was obtained from 48 normoglycemic women who underwent surgery. Expression levels of mRNA and proteins were measured for mitochondrial chaperones, intrinsic proteases, and components of electron-transport chains. Furthermore, we systematically analyzed metabolic phenotypes with a large panel of isogenic BXD inbred mouse strains and Genotype-Tissue Expression (GTEx) data.
Results
In VAT, expression of mitochondrial chaperones and intrinsic proteases localized in inner and outer mitochondrial membranes was not associated with body mass index (BMI), except for the Lon protease homolog, mitochondrial, and the corresponding gene LONP1, which showed high-level expression in the VAT of overweight or obese individuals. Expression of LONP1 in VAT positively correlated with BMI. Analysis of the GTEx database revealed that elevation of LONP1 expression is associated with enhancement of genes involved in glucose and lipid metabolism in VAT. Mice with higher Lonp1 expression in adipose tissue had better systemic glucose metabolism than mice with lower Lonp1 expression.
Conclusion
Expression of mitochondrial LONP1, which is involved in the mitochondrial quality control stress response, was elevated in the VAT of obese individuals. In a bioinformatics analysis, high LONP1 expression in VAT was associated with enhanced glucose and lipid metabolism.

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Enhanced mitochondrial biogenesis facilitates the development of cutaneous squamous cell carcinoma
Ziyang Wang, Ke He, Meng Liu, Weiqiang Lv, Baochen Cheng, Guanfei Zhang, Xueqiang Wang, Mengqi Zeng, Lianying Jiao, Shujun Han, Yan Zheng, Zhihui Feng
Cancer Letters.2025; 618: 217623. CrossRef
LONP1 facilitates pulmonary artery smooth muscle cell glycolytic reprogramming by degrading MPC1 in pulmonary hypertension
Mingkang Li, Wenkang Zhang, Minhao Zhang, Linqing Li, Yuyu Yao, Yuhan Qin, Dong Wang, Gaoliang Yan, Yong Qiao, Chengchun Tang
Clinical Science.2025; 139(10): 479. CrossRef
LONP1 ameliorates liver injury and improves gluconeogenesis dysfunction in acute-on-chronic liver failure
Muchen Wu, Jing Wu, Kai Liu, Minjie Jiang, Fang Xie, Xuehong Yin, Jushan Wu, Qinghua Meng
Chinese Medical Journal.2024; 137(2): 190. CrossRef
Tissue‐specific roles of mitochondrial unfolded protein response during obesity
Fernanda S. Carneiro, Carlos K. Katashima, Joshua D. Dodge, Dennys E. Cintra, José Rodrigo Pauli, Adelino S. R. Da Silva, Eduardo R. Ropelle
Obesity Reviews.2024;[Epub] CrossRef
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Jiangnan Zhang, Wenliang Qiao, Youfu Luo
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Ekaterina Sergeeva, Tatiana Ruksha, Yulia Fefelova
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Natalia Todosenko, Olga Khaziakhmatova, Vladimir Malashchenko, Kristina Yurova, Maria Bograya, Maria Beletskaya, Maria Vulf, Natalia Gazatova, Larisa Litvinova
International Journal of Molecular Sciences.2023; 24(15): 12012. CrossRef
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Yuan Xie, Shuwen Chen, Zaixin Guo, Ying Tian, Xinyu Hong, Penghui Feng, Qiu Xie, Qi Yu
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Ageing Research Reviews.2022; 81: 101702. CrossRef

Clinical Study
Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity: Suji Yoo, Jaehoon Jung, Hosu Kim, Kyoung Young Kim, Soo Kyoung Kim, Jungwha Jung, Jong Ryeal Hahm, Jong Ha Baek; Endocrinol Metab. 2020;35(4):873-881. Published online December 23, 2020; DOI: https://doi.org/10.3803/EnM.2020.798

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Background
To examine whether glycated hemoglobin (HbA1c) test would be a suitable screening tool for detecting high-risk subjects for diabetes compared to oral glucose tolerance test (OGTT) according to accompanied central obesity.
Methods
In this prospective population-based cohort study, both OGTT and HbA1c tests were performed and continued every 2 years up to 12 years among individuals with non-diabetic state at baseline (aged 40 to 69 years, n=7,512). Incident diabetes was established by a doctor, HbA1c ≥6.5%, and/or fasting plasma glucose (FPG) ≥126 mg/dL, and/or 2-hour postprandial glucose (2hPG) level based on OGTT ≥200 mg/dL. Discriminative capacities of high HbA1c (≥5.7%) versus high 2hPG (≥140 mg/dL) for predicting incident diabetes were compared using Cox-proportional hazard regression and C-index.
Results
During the median 11.5 years of follow-up period, 1,341 (17.6%) developed diabetes corresponding to an incidence of 22.1 per 1,000 person-years. Isolated high 2hPG was associated with higher risk for incident diabetes (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.56 to 5.17) than isolated high HbA1c (HR, 2.79; 95% CI, 2.40 to 3.26; P<0.05). In addition, high 2hPG provided better discriminatory capacity than high HbA1c (C-index 0.79 vs. 0.75, P<0.05). Meanwhile, in subjects with central obesity, the HR (3.95 [95% CI, 3.01 to 5.18] vs. 2.82 [95% CI, 2.30 to 3.46]) and discriminatory capacity of incident diabetes (C-index 0.75 vs. 0.75) between two subgroups became comparable.
Conclusion
Even though the overall inferior predictive capacity of HbA1c test than OGTT, HbA1c test might plays a complementary role in identifying high risk for diabetes especially in subjects with central obesity with increased sensitivity.

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Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults
Jung-Hwan Kim, Yaeji Lee, Chung-Mo Nam, Yu-Jin Kwon, Ji-Won Lee
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Review Articles

Obesity and Metabolism
Genetic and Environmental Factors Contributing to Visceral Adiposity in Asian Populations: Rachel Williams, Muthu Periasamy; Endocrinol Metab. 2020;35(4):681-695. Published online December 23, 2020; DOI: https://doi.org/10.3803/EnM.2020.772

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Obesity-associated metabolic illnesses are increasing at an alarming rate in Asian countries. A common feature observed in the Asian population is a higher incidence of abdominal obesity—the “skinny-fat” Asian syndrome. In this review, we critically evaluate the relative roles of genetics and environmental factors on fat distribution in Asian populations. While there is an upward trend in obesity among most Asian countries, it appears particularly conspicuous in Malaysia. We propose a novel theory, the Malaysian gene-environment multiplier hypothesis, which explains how ancestral variations in feast-and-famine cycles contribute to inherited genetic predispositions that, when acted on by modern-day stressors—most notably, urbanization, westernization, lifestyle changes, dietary transitions, cultural pressures, and stress—contribute to increased visceral adiposity in Asian populations. At present, the major determinants contributing to visceral adiposity in Asians are far from conclusive, but we seek to highlight critical areas for further research.

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Obesity and Metabolism
Metabolically Healthy and Unhealthy Normal Weight and Obesity: Norbert Stefan; Endocrinol Metab. 2020;35(3):487-493. Published online August 20, 2020; DOI: https://doi.org/10.3803/EnM.2020.301

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Increased fat mass is an established risk factor for the cardiometabolic diseases type 2 diabetes and cardiovascular disease (CVD) and is associated with increased risk of all-cause and CVD mortality. However, also very low fat mass associates with such an increased risk. Whether impaired metabolic health, characterized by hypertension, dyslipidemia, hyperglycemia, insulin resistance, and subclinical inflammation, may explain part of the elevated risk of cardiometabolic diseases that is found in many subjects with very low fat mass, as it does in many obese subjects, is unknown. An important pathomechanism of impaired metabolic health is disproportionate fat distribution. In this article the risk of cardiometabolic diseases and mortality in subjects with metabolically healthy and unhealthy normal weight and obesity is summarized. Furthermore, the change of metabolic health during a longer period of follow-up and its impact on cardiometabolic diseases is being discussed. Finally, the implementation of the concept of metabolic health in daily clinical practice is being highlighted.

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Original Articles

Clinical Study
Apolipoprotein B Levels Predict Future Development of Hypertension Independent of Visceral Adiposity and Insulin Sensitivity: Seung Jin Han, Wilfred Y. Fujimoto, Steven E. Kahn, Donna L. Leonetti, Edward J. Boyko; Endocrinol Metab. 2020;35(2):351-358. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.351

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Background
High plasma apolipoprotein B (apoB) levels have been shown to be associated with hypertension, central obesity, and insulin resistance in cross-sectional research. However, it is unclear whether apoB levels predict future hypertension independent of body composition and insulin sensitivity. Therefore, we prospectively investigated whether plasma apoB concentrations independently predicted the risk of hypertension in a cohort of Japanese Americans.
Methods
A total of 233 normotensive Japanese Americans (77 men, 156 women; mean age, 46.4±11.0 years) were followed over 10 years to monitor them for the development of hypertension. Fasting plasma concentrations of apoB, glucose, and insulin were measured at baseline. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). The abdominal visceral and subcutaneous fat areas were measured at baseline using computed tomography. Logistic regression analysis was used to estimate the association between apoB concentrations and the odds of incident hypertension.
Results
The 10-year cumulative incidence of hypertension was 21.5%. The baseline apoB level was found to be positively associated with the odds of incident hypertension over 10 years after adjustment for age, sex, body mass index, systolic blood pressure, abdominal visceral fat area, abdominal subcutaneous fat area, total plasma cholesterol concentration, diabetes status, and HOMA-IR at baseline (odds ratio and 95% confidence interval for a 1-standard deviation increase, 1.89 [1.06 to 3.37]; P=0.030).
Conclusion
Higher apoB concentrations predicted greater risks of future hypertension independent of abdominal visceral fat area and insulin sensitivity in Japanese Americans.

Citations

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Clinical Study
Visceral-to-Subcutaneous Abdominal Fat Ratio Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis: Chan-Hee Jung, Eun-Jung Rhee, Hyemi Kwon, Yoosoo Chang, Seungho Ryu, Won-Young Lee; Endocrinol Metab. 2020;35(1):165-176. Published online March 19, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.1.165

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Background

We evaluated the association of visceral-to-subcutaneous fat ratio (VSR) with nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis degree based on noninvasive serum fibrosis markers in the general population with NAFLD.

Methods

This is a cross-sectional study, in 7,465 Korean adults who underwent health screening examinations. NAFLD was defined as fatty liver detected on ultrasonography, and visceral and subcutaneous abdominal fat was measured using computed tomography. We predicted fibrosis based on the fibrosis-4 (FIB-4) score and aspartate aminotransferase-to-platelet ratio index (APRI) and categorized the risk for advanced fibrosis as low, indeterminate, or high.

Results

The multivariable-adjusted prevalence ratios for indeterminate to high risk of advanced fibrosis based on FIB-4, determined by comparing the second, third, and fourth quartiles with the first quartile of VSR, were 3.38 (95% confidence interval [CI], 0.64 to 17.97), 9.41 (95% CI, 1.97 to 45.01), and 19.34 (95% CI, 4.06 to 92.18), respectively. The multivariable-adjusted prevalence ratios for intermediate to high degree of fibrosis according to APRI also increased across VSR quartiles (5.04 [95% CI, 2.65 to 9.59], 7.51 [95% CI, 3.91 to 14.42], and 19.55 [95% CI, 9.97 to 38.34], respectively). High VSR was more strongly associated with the prevalence of NAFLD in nonobese subjects than in obese subjects, and the associations between VSR and intermediate to high probability of advanced fibrosis in NAFLD were stronger in obese subjects than in nonobese subjects.

Conclusion

High VSR values predicted increased NAFLD risk and advanced fibrosis risk with NAFLD, and the predictive value of VSR for indeterminate to high risk of advanced fibrosis was higher in obese subjects than in nonobese subjects.

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Clinical Study
Associations of Perirenal Fat Thickness with Renal and Systemic Calcified Atherosclerosis: Bo Kyung Koo, Julie O. Denenberg, C. Michael Wright, Michael H. Criqui, Matthew A. Allison; Endocrinol Metab. 2020;35(1):122-131. Published online March 19, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.1.122

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Background

We investigated associations between perirenal fat thickness and atherosclerotic calcification in six different vascular beds.

Methods

Using a community-based cohort (n=3,919), perirenal fat thickness was estimated from computed tomography scans. It was classified as Q1 (the lowest quartile) to Q4 (the highest quartile) in each sex. Calcification in the carotid arteries, coronary arteries, thoracic aorta, abdominal aorta, iliac arteries, and renal arteries was evaluated.

Results

Perirenal fat thickness was associated with older age (P<0.01) and a higher prevalence of obesity, hypertension, and dyslipidemia (P<0.01 for all). Perirenal fat thickness was independently associated with renal arterial calcification even after adjustment for age, sex, body mass index, hypertension, dyslipidemia, smoking history, and family history of heart diseases in first-degree relatives (odds ratio [OR] per quartile of perirenal fat thickness, 1.25; 95% confidence interval [CI], 1.09 to 1.44). Compared to Q1, the odds of renal arterial calcification in Q4 was about two times higher (OR, 2.05; 95% CI, 1.29 to 3.25). After adjustment for renal arterial calcification and atherosclerotic risk factors, the only other vascular bed where perirenal fat thickness showed a significant association with calcification was the abdominal aorta (OR, 1.11; 95% CI, 1.00 to 1.23; P=0.045).

Conclusion

Perirenal fat thickness was independently associated with vascular calcification in the renal artery and abdominal aorta.

Citations

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Perirenal fat differs in patients with chronic kidney disease receiving different vitamin D-based treatments: a preliminary study
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Perirenal fat area is a preoperative predictor of hypertension resolution after laparoscopic sleeve gastrectomy: Generalized additive models
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The correlation of perirenal fat and atherosclerosis: A systematic review and meta-analysis
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Perirenal fat thickness is an independent predictor for metabolic syndrome in steatotic liver disease
Jong Wook Choi, Chul-min Lee, Bo-Kyeong Kang, Mimi Kim
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Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012: Kyung Min Ko, Kyungdo Han, Youn Jee Chung, Kun-Ho Yoon, Yong Gyu Park, Seung-Hwan Lee; Endocrinol Metab. 2017;32(2):248-256. Published online June 23, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.2.248

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Background

Menstrual irregularity is an indicator of endocrine disorders and reproductive health status. It is associated with various diseases and medical conditions, including obesity and underweight. We aimed to assess the association between body weight changes and menstrual irregularity in Korean women.

Methods

A total of 4,621 women 19 to 54 years of age who participated in the 2010 to 2012 Korea National Health and Nutrition Examination Survey were included in this study. Self-reported questionnaires were used to collect medical information assessing menstrual health status and body weight changes. Odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between body weight changes and menstrual irregularity.

Results

Significantly higher ORs (95% CI) were observed in the association between menstrual irregularity and both weight loss (OR, 1.74; 95% CI, 1.22 to 2.48) and weight gain (OR, 1.45; 95% CI, 1.13 to 1.86) after adjusting for age, body mass index, current smoking, heavy alcohol drinking, regular exercise, calorie intake, education, income, metabolic syndrome, age of menarche, parity, and stress perception. Of note, significant associations were only observed in subjects with obesity and abdominal obesity, but not in non-obese or non-abdominally obese subjects. U-shaped patterns were demonstrated in both obese and abdominally obese subjects, indicating that greater changes in body weight are associated with higher odds of menstrual irregularity.

Conclusion

We found a U-shaped pattern of association between body weight changes and menstrual irregularity among obese women in the general Korean population. This result indicates that not only proper weight management but also changes in body weight may influence the regulation of the menstrual cycle.

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Review Article

Bone Metabolism
Dual-Energy X-Ray Absorptiometry: Beyond Bone Mineral Density Determination: Yong Jun Choi; Endocrinol Metab. 2016;31(1):25-30. Published online March 16, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.1.25

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Abstract PDF PubReader

Significant improvements in dual-energy X-ray absorptiometry (DXA) concerning quality, image resolution and image acquisition time have allowed the development of various functions. DXA can evaluate bone quality by indirect analysis of micro- and macro-architecture of the bone, which and improve the prediction of fracture risk. DXA can also detect existing fractures, such as vertebral fractures or atypical femur fractures, without additional radiologic imaging and radiation exposure. Moreover, it can assess the metabolic status by the measurement of body composition parameters like muscle mass and visceral fat. Although more studies are required to validate and clinically use these parameters, it is clear that DXA is not just for bone mineral densitometry.

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Original Article

Obesity and Metabolism
Sugar-Sweetened Beverage Consumption Is Associated with Metabolic Syndrome in Iranian Adults: Tehran Lipid and Glucose Study: Hanieh-Sadat Ejtahed, Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi; Endocrinol Metab. 2015;30(3):334-342. Published online May 18, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.3.334

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Background

Metabolic syndrome (MetS), a cluster of multiple metabolic abnormalities, is one of the major public health challenges worldwide. The current study was conducted to evaluate the association between sugar-sweetened beverage (SSB) consumption and MetS and its components in Iranian adults.

Methods

This cross-sectional study was conducted among 5,852 men and women, aged 19 to 70 years, who participated in the fourth phase (2009 to 2011) of the Tehran Lipid and Glucose Study. Demographics, anthropometrics, biochemical measurements, and blood pressure (BP) were assessed and MetS was defined by National Cholesterol Education Program Adult Treatment Panel III definition. Frequency and quantity of SSB intakes including carbonated drinks and synthetic fruit juices were collected using a validated semiquantitative food frequency questionnaire.

Results

Mean age of participants (43%, men) was 40.6±12.9 years. Significant positive associations between SSBs and waist circumference, triglyceride level, systolic and diastolic BP in the third and fourth quartile of SSBs were observed, after adjustment for all potential confounding variables. The odds of MetS in the third and fourth quartiles compared to the first quartile category of SSBs was 1.21 (95% confidence interval [CI], 1.01 to 1.45) and 1.30 (95% CI, 1.06 to 1.58), respectively (P for trend=0.03). The odds of MetS, abdominal obesity, low high density lipoprotein cholesterol and elevated BP had increasing trends across increasing of SSB consumption (P for trend <0.05).

Conclusion

Higher intake of SSBs was associated with the higher odds of MetS in adults. It is suggested that reducing consumption of SSBs could be a practical approach to prevent metabolic abnormalities.

Citations

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Review Article

Obesity and Metabolism
Optimal Waist Circumference Cutoff Values for the Diagnosis of Abdominal Obesity in Korean Adults: Yeong Sook Yoon, Sang Woo Oh; Endocrinol Metab. 2014;29(4):418-426. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.418

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Abdominal obesity is associated closely with insulin resistance, diabetes, and cardiovascular disease. Waist circumference (WC) is a useful surrogate marker commonly used for abdominal adiposity. The determination of WC cutoff levels is important in the prevention and treatment of obesity, type 2 diabetes, and related cardiovascular diseases. Recent epidemiological evidence suggested that appropriate optimal cutoffs for Koreans ranged over 80 to 89.8 cm in males and 76.1 to 86.5 cm in females. We analyzed the data from two large cohorts using receiver operating characteristic curve analysis with the incidences of diabetes, hypertension, dyslipidemia, cerebrovascular disease, myocardial infarct, angina, coronary artery disease, and multiple metabolic risk factors as outcome variables. Optimal WC cutoff points for Koreans were 85 cm in males and 80 cm in females. However, considering the prevalence of abdominal obesity and the health costs for its prevention and management, 90 cm in males and 85 cm in females are probably more appropriate thresholds for abdominal obesity. These values may be modified once better research is performed through prospective studies using representative populations, common health outcomes, and proper analytical approaches.

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Scientific Reports.2021;[Epub] CrossRef
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The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S90. CrossRef
Individual and Synergistic Relationships of Low Muscle Mass and Low Muscle Function with Depressive Symptoms in Korean Older Adults
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International Journal of Environmental Research and Public Health.2021; 18(19): 10129. CrossRef
Association between Metabolic Syndrome and the Number of Remaining Teeth in Postmenopausal Women: A Cross-Sectional Analysis Using the Korean National Health and Nutritional Examination Survey
Jeong-In Kim, Choong-Ho Choi, Ki-Ho Chung
Journal of Clinical Medicine.2021; 10(20): 4759. CrossRef
No Association between Metabolic Syndrome and Periodontitis in Korean Postmenopausal Women
Jeong-In Kim, Choong-Ho Choi, Ki-Ho Chung
International Journal of Environmental Research and Public Health.2021; 18(21): 11110. CrossRef
Relative Lean Body Mass and Waist Circumference for the Identification of Metabolic Syndrome in the Korean General Population
Eunjoo Kwon, Eun-Hee Nah, Suyoung Kim, Seon Cho
International Journal of Environmental Research and Public Health.2021; 18(24): 13186. CrossRef
SVM-based waist circumference estimation using Kinect
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Computer Methods and Programs in Biomedicine.2020; 191: 105418. CrossRef
Effects of abdominal obesity on the association between air pollution and kidney function
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International Journal of Obesity.2020; 44(7): 1568. CrossRef
Effect of sarcopenic obesity on deterioration of physical function in the elderly
Hyun Ho Kong, Chang Won Won, Won Kim
Archives of Gerontology and Geriatrics.2020; 89: 104065. CrossRef
Effects of low skeletal muscle mass and sarcopenic obesity on albuminuria: a 7-year longitudinal study
Jee Hee Yoo, Gyuri Kim, Sung Woon Park, Min Sun Choi, Jiyeon Ahn, Sang-Man Jin, Kyu Yeon Hur, Moon-Kyu Lee, Mira Kang, Jae Hyeon Kim
Scientific Reports.2020;[Epub] CrossRef
A Novel Indicator of Children’s Lipid Accumulation Product Associated with Impaired Fasting Glucose in Chinese Children and Adolescents

Yongting Yuan, Hong Xie, Lili Sun, Bangxuan Wang, Li Zhang, Hui Han, Rongying Yao, Yehuan Sun, Lianguo Fu
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 1653. CrossRef
The Association between the Ratio of Energy Intake to Basal Metabolic Rate and Physical Activity to Sarcopenia: Using the Korea National Health and Nutrition Examination Surveys (2008–2011)
Yu Jin Cho, Mi Hee Cho, Bomi Han, Minji Park, Seolah Bak, Minseon Park
Korean Journal of Family Medicine.2020; 41(3): 167. CrossRef
Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity
Robert Ross, Ian J. Neeland, Shizuya Yamashita, Iris Shai, Jaap Seidell, Paolo Magni, Raul D. Santos, Benoit Arsenault, Ada Cuevas, Frank B. Hu, Bruce A. Griffin, Alberto Zambon, Philip Barter, Jean-Charles Fruchart, Robert H. Eckel, Yuji Matsuzawa, Jean-
Nature Reviews Endocrinology.2020; 16(3): 177. CrossRef
Lung function as a predictor of incident type 2 diabetes in community-dwelling adults: A longitudinal finding over 12 years from the Korean Genome and Epidemiology Study
J.H. Lee, H.S. Lee, Y.J. Lee
Diabetes & Metabolism.2020; 46(5): 392. CrossRef
Sex- and age-specific effects of energy intake and physical activity on sarcopenia
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Scientific Reports.2020;[Epub] CrossRef
Protective effect of smoking cessation on subsequent myocardial infarction and ischemic stroke independent of weight gain: A nationwide cohort study
Jung-Hwan Cho, Hye-Mi Kwon, Se-Eun Park, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Eun-Jung Rhee, Won-Young Lee, Michael Cummings
PLOS ONE.2020; 15(7): e0235276. CrossRef
Optimal Cutoff Values for Anthropometric Adiposity Measures of Sri Lankan Adult Women
Nirmala Rathnayake, Gayani Alwis, Janaka Lenora, Sarath Lekamwasam
Journal of Obesity.2020; 2020: 1. CrossRef
Differences in the Association Among the Vitamin D Concentration, Dietary Macronutrient Consumption, and Metabolic Syndrome Depending on Pre- and Postmenopausal Status in Korean Women: A Cross-Sectional Study

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Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 3601. CrossRef
Patterns of change in cardiovascular risks of Korean male workers: a 10-year cohort analysis using the National Health Insurance Service–National Sample Cohort (NHIS-NSC) 2.0 database
Hosihn Ryu, Jiyeon Jung, Jihyun Moon
BMJ Open.2020; 10(11): e038446. CrossRef
Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity
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Endocrinology and Metabolism.2020; 35(4): 873. CrossRef
Metabolic Syndrome and Risk of Lung Cancer: An Analysis of Korean National Health Insurance Corporation Database
Sooim Sin, Chang-Hoon Lee, Sun Mi Choi, Kyung-Do Han, Jinwoo Lee
The Journal of Clinical Endocrinology & Metabolism.2020; 105(11): e4102. CrossRef
Association of body mass index with bladder cancer risk in men depends on abdominal obesity
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World Journal of Urology.2019; 37(11): 2393. CrossRef
Lower Leg Fat Depots Are Associated with Albuminuria Independently of Obesity, Insulin Resistance, and Metabolic Syndrome (Korea National Health and Nutrition Examination Surveys 2008 to 2011)
Eugene Han, Nan Hee Cho, Mi Kyung Kim, Hye Soon Kim
Diabetes & Metabolism Journal.2019; 43(4): 461. CrossRef
The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
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Diabetes & Metabolism Journal.2019; 43(2): 206. CrossRef
Association between Serum Gamma-Glutamyltransferase and Prevalence of Metabolic Syndrome Using Data from the Korean Genome and Epidemiology Study
Mi Young Lee, Dae Sung Hyon, Ji Hye Huh, Hae Kyung Kim, Sul Ki Han, Jang Young Kim, Sang Baek Koh
Endocrinology and Metabolism.2019; 34(4): 390. CrossRef
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Korean Journal of Family Medicine.2019; 40(3): 176. CrossRef
Sex differences in the association between asthma incidence and modifiable risk factors in Korean middle-aged and older adults: NHIS-HEALS 10-year cohort
Susan Park, Sun-Young Jung, Jin-Won Kwon
BMC Pulmonary Medicine.2019;[Epub] CrossRef
Plasma sphingomyelins increase in pre-diabetic Korean men with abdominal obesity
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PLOS ONE.2019; 14(3): e0213285. CrossRef
Estimating the Cutoff Points of Time-Dependent Risk Factors by Using Joint Modeling of Longitudinal and Time-to-Event Data: A 14-Year Follow-up Study—Tehran Lipid and Glucose Study
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Asia Pacific Journal of Public Health.2019; 31(8): 728. 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
Trends and Cut-Point Changes in Obesity Parameters by Age Groups Considering Metabolic Syndrome
Hyung Jun Park, Young Ho Hong, Yun Jung Cho, Ji Eun Lee, Jae Moon Yun, Hyuktae Kwon, Sang Hyuck Kim
Journal of Korean Medical Science.2018;[Epub] CrossRef
Difference in prostate cancer incidence around sixty years: effects of age and metabolic diseases
Jin Bong Choi, Jung Ho Kim, Sung‐Hoo Hong, Kyung‐Do Han, U‐Syn Ha
Cancer Medicine.2018; 7(6): 2736. CrossRef
The Association of Low Back Pain with Obesity and Abdominal Obesity among Koreans Aged 50 Years or More
Eun Young Choi
Korean Journal of Health Promotion.2018; 18(3): 119. CrossRef
Association between oral health and colorectal adenoma in a screening population
Donghyoun Lee, Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Ho-Kyung Chun
Medicine.2018; 97(37): e12244. CrossRef
An association of metabolic syndrome and chronic kidney disease from a 10-year prospective cohort study
Ji Hye Huh, Dhananjay Yadav, Jae Seok Kim, Jung-Woo Son, Eunhee Choi, Seong Hwan Kim, Chol Shin, Ki-Chul Sung, Jang Young Kim
Metabolism.2017; 67: 54. CrossRef
Anatomic fat depots and cardiovascular risk: a focus on the leg fat using nationwide surveys (KNHANES 2008–2011)
Eugene Han, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, In-Kyu Lee, Bong-Soo Cha
Cardiovascular Diabetology.2017;[Epub] CrossRef
Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012
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Endocrinology and Metabolism.2017; 32(2): 248. CrossRef
Low muscle mass and risk of type 2 diabetes in middle-aged and older adults: findings from the KoGES
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Diabetologia.2017; 60(5): 865. CrossRef
Safety and efficacy of a non-contact radiofrequency device for body contouring in Asians
Dong Hye Suh, Chang Min Kim, Sang Jun Lee, Hyunjoo Kim, Suk Keu Yeom, Hwa Jung Ryu
Journal of Cosmetic and Laser Therapy.2017; 19(2): 89. CrossRef
Arterial stiffness and its association with clustering of metabolic syndrome risk factors
Wanda R. P. Lopes-Vicente, Sara Rodrigues, Felipe X. Cepeda, Camila Paixão Jordão, Valéria Costa-Hong, Akothirene C. B. Dutra-Marques, Jefferson C. Carvalho, Maria Janieire N. N. Alves, Luiz A. Bortolotto, Ivani C. Trombetta
Diabetology & Metabolic Syndrome.2017;[Epub] CrossRef
Associations of sitting time and occupation with metabolic syndrome in South Korean adults: a cross-sectional study
Jin Young Nam, Juyoung Kim, Kyung Hee Cho, Young Choi, Jaewoo Choi, Jaeyong Shin, Eun-Cheol Park
BMC Public Health.2016;[Epub] CrossRef
Associations of Obesity and Dyslipidemia with Intake of Sodium, Fat, and Sugar among Koreans: a Qualitative Systematic Review
Yoon Jung Kang, Hye Won Wang, Se Young Cheon, Hwa Jung Lee, Kyung Mi Hwang, Hae Seong Yoon
Clinical Nutrition Research.2016; 5(4): 290. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef
Ambient Temperature and Prevalence of Obesity: A Nationwide Population-Based Study in Korea
Hae Kyung Yang, Kyungdo Han, Jae-Hyoung Cho, Kun-Ho Yoon, Bong-Yun Cha, Seung-Hwan Lee, David Meyre
PLOS ONE.2015; 10(11): e0141724. CrossRef
Acupoint Catgut Embedding for Obesity: Systematic Review and Meta-Analysis
Taipin Guo, Yulan Ren, Jun Kou, Jing Shi, Sun Tianxiao, Fanrong Liang
Evidence-Based Complementary and Alternative Medicine.2015; 2015: 1. CrossRef
Elderly men over 65 years of age with late-onset hypogonadism benefit as much from testosterone treatment as do younger men
Farid Saad, Aksam Yassin, Ahmad Haider, Gheorghe Doros, Louis Gooren
Korean Journal of Urology.2015; 56(4): 310. CrossRef
Administration of Hwang-Ryun-Haedok-tang, a Herbal Complex, for Patients With Abdominal Obesity: A Case Series
Seungwon Kwon, WooSang Jung, A Ri Byun, SangKwan Moon, KiHo Cho, KyoungHo Shin
EXPLORE.2015; 11(5): 401. CrossRef

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