Seungbong Han, Young-Jee Jeon, Gyung-Min Park, Tae Young Lee, Soon Eun Park, Gyeongseok Yu, Byung Ju Kang
{"title":"Differences in Abdominal Body Composition According to Glycemic Status: An Inverse Probability Treatment Weighting Analysis.","authors":"Seungbong Han, Young-Jee Jeon, Gyung-Min Park, Tae Young Lee, Soon Eun Park, Gyeongseok Yu, Byung Ju Kang","doi":"10.3803/EnM.2021.1086","DOIUrl":"https://doi.org/10.3803/EnM.2021.1086","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"855-864"},"PeriodicalIF":3.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/14/enm-2021-1086.PMC8419614.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39298013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Role of Thyroid Hormone in the Regulation of Cerebellar Development.","authors":"Sumiyasu Ishii, Izuki Amano, Noriyuki Koibuchi","doi":"10.3803/EnM.2021.1150","DOIUrl":"https://doi.org/10.3803/EnM.2021.1150","url":null,"abstract":"<p><p>The proper organized expression of specific genes in time and space is responsible for the organogenesis of the central nervous system including the cerebellum. The epigenetic regulation of gene expression is tightly regulated by an intrinsic intracellular genetic program, local stimuli such as synaptic inputs and trophic factors, and peripheral stimuli from outside of the brain including hormones. Some hormone receptors are expressed in the cerebellum. Thyroid hormones (THs), among numerous circulating hormones, are well-known major regulators of cerebellar development. In both rodents and human, hypothyroidism during the postnatal developmental period results in abnormal morphogenesis or altered function. THs bind to the thyroid hormone receptors (TRs) in the nuclei and with the help of transcriptional cofactors regulate the transcription of target genes. Gene regulation by TR induces cell proliferation, migration, and differentiation, which are necessary for brain development and plasticity. Thus, the lack of TH action mediators may directly cause aberrant cerebellar development. Various kinds of animal models have been established in a bid to study the mechanism of TH action in the cerebellum. Interestingly, the phenotypes differ greatly depending on the models. Herein we summarize the actions of TH and TR particularly in the developing cerebellum.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"703-716"},"PeriodicalIF":3.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/b1/enm-2021-1150.PMC8419606.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39298990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sun Joon Moon, Han Na Jang, Jung Hee Kim, Min Kyong Moon
{"title":"Lipid Profiles in Primary Aldosteronism Compared with Essential Hypertension: Propensity-Score Matching Study.","authors":"Sun Joon Moon, Han Na Jang, Jung Hee Kim, Min Kyong Moon","doi":"10.3803/EnM.2021.1012","DOIUrl":"https://doi.org/10.3803/EnM.2021.1012","url":null,"abstract":"<p><strong>Background: </strong>There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function.</p><p><strong>Methods: </strong>Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively.</p><p><strong>Results: </strong>Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed.</p><p><strong>Conclusion: </strong>PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"885-894"},"PeriodicalIF":3.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/ec/enm-2021-1012.PMC8419600.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39297628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyungsik Kim, Mijin Kim, Woojin Lim, Bo Hyun Kim, Sue K Park
{"title":"The Concept of Economic Evaluation and Its Application in Thyroid Cancer Research.","authors":"Kyungsik Kim, Mijin Kim, Woojin Lim, Bo Hyun Kim, Sue K Park","doi":"10.3803/EnM.2021.1164","DOIUrl":"https://doi.org/10.3803/EnM.2021.1164","url":null,"abstract":"<p><p>Economic evaluation is a type of comparative analysis between interventions in terms of both their resource use and health outcomes. Due to the good prognosis of thyroid cancer (TC), the socioeconomic burden of TC patients post-diagnosis is increasing. Therefore, economic evaluation studies focusing on TC are recommended. This study aimed to describe the concept and methods of economic evaluation and reviewed previous TC studies. Several previous studies compared the costs of interventions or evaluated recurrence, complications, or quality of life as measures of their effectiveness. Regarding costs, most studies focused on direct costs and applied hypothetical models. Cost-minimization analysis should be distinguished from simple cost analysis. Furthermore, due to the universality of the term \"cost-effectiveness analysis\" (CEA), several studies have not distinguished CEA from cost-utility analysis; this point needs to be considered in future research. Cost-benefit analyses have not been conducted in previous TC research. Since TC has a high survival rate and good prognosis, the need for economic evaluations has recently been pointed out. Therefore, correct concepts and methods are needed to obtain clear economic evaluation results. On this basis, it will be possible to provide appropriate guidelines for TC treatment and management in the future.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"725-736"},"PeriodicalIF":3.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/46/enm-2021-1164.PMC8419602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39379515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preventing Rebound-Associated Fractures after Discontinuation of Denosumab Therapy: A Position Statement from the Health Insurance Committee of the Korean Endocrine Society.","authors":"Bu Kyung Kim, Chong Hwa Kim, Yong-Ki Min","doi":"10.3803/EnM.2021.1193","DOIUrl":"https://doi.org/10.3803/EnM.2021.1193","url":null,"abstract":"Denosumab was approved for use in Korea in 2017, and its use has been rapidly increasing since it was classified as a reimbursable initial therapy for osteoporosis in April 2019. South Korea has a national health insurance system that enables all citizens to benefit from medical services with ease. Nonetheless, a problematic reality is that clinicians’ decision-making process in real-world practice is more directly affected by health insurance reimbursement policies than by medical guidelines. The American Association of Clinical Endocrinology (AACE) and the Endocrine Society recommend denosumab as the initial treatment for patients at high or very high risk for osteoporotic fracture [1,2]. It has demonstrated superior efficacy for osteoporosis treatment, as a single subcutaneous injection of 60 mg once every 6 months reduces the incidence of vertebral fractures by 60%, nonvertebral fractures by 20%, and hip fractures by 40% over 3 years [3]. Moreover, the Fracture Reduction Evaluation of Denosumab in Osteoporosis Every 6 Months (FREEDOM) extended study demonstrated that denosumab continued to increase bone density for 10 years [4]. However, this elevated bone density decreases rapidly after the discontinuation of denosumab. In FREEDOM extended study, the bone mineral density (BMD) that had risen for 10 years decreased sharply during just 1 year after discontinuation. Of particular note, femoral BMD decreased to an even lower level than baseline. This is well known to be due to the rebound of bone turnover markers after discontinuation of denosumab. During this rapid bone loss period, some patients have also been reported to experience rebound-associated fractures [4,5]. Rebound-associated fractures are not encountered in all patients; however, once they occur, they lead to multiple vertebral fractures, which can result in serious problems [6]. Rebound-associated fractures can be prevented by using other anti-resorptive agents [7]. In patients who received alendronate after discontinuation of denosumab, their BMD, which had","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"909-911"},"PeriodicalIF":3.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/06/1b/enm-2021-1193.PMC8419613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39377971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jin Young Lee, Da Ae Kim, Eunah Choi, Yun Sun Lee, So Jeong Park, Beom-Jun Kim
{"title":"Aldosterone Inhibits In Vitro Myogenesis by Increasing Intracellular Oxidative Stress via Mineralocorticoid Receptor.","authors":"Jin Young Lee, Da Ae Kim, Eunah Choi, Yun Sun Lee, So Jeong Park, Beom-Jun Kim","doi":"10.3803/EnM.2021.1108","DOIUrl":"https://doi.org/10.3803/EnM.2021.1108","url":null,"abstract":"<p><strong>Background: </strong>Despite clinical evidence indicating poor muscle health in subjects with primary aldosteronism (PA), it is still unclear whether the role of aldosterone in muscle metabolism is direct or mediated indirectly via factors, such as electrolyte imbalance or impaired glucose uptake. As one approach to clarify this issue, we investigated the effect of aldosterone on in vitro myogenesis and the potential mechanism explaining it.</p><p><strong>Methods: </strong>Myogenesis was induced in mouse C2C12 myoblasts with 2% horse serum. Immunofluorescence, quantitative reversetranscription polymerase chain reaction, Western blot, viability, and migration analyses were performed for experimental research.</p><p><strong>Results: </strong>Recombinant aldosterone treatment suppressed muscle differentiation from mouse C2C12 myoblasts in a dose-dependent manner, and consistently reduced the expression of myogenic differentiation markers. Furthermore, aldosterone significantly increased intracellular reactive oxygen species (ROS) levels in myotubes, and treatment with N-acetyl cysteine, a potent biological thiol antioxidant, reversed the decrease of myotube area, myotube area per myotube, nucleus number per myotube, and fusion index due to aldosterone through decreasing oxidative stress. A binding enzyme-linked immunosorbent assay confirmed that mineralocorticoid receptor (MR) interacted with aldosterone in C2C12 myoblasts, while eplerenone, an MR inhibitor, blocked aldosterone-stimulated intracellular ROS generation during myogenesis and markedly attenuated the suppression of in vitro myogenesis by aldosterone.</p><p><strong>Conclusion: </strong>These findings support the hypothesis that hypersecretion of aldosterone, like PA, directly contributes to muscular deterioration and suggest that antioxidants and/or MR antagonists could be effective therapeutic options to reduce the risk of sarcopenia in these patients.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"865-874"},"PeriodicalIF":3.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/0c/enm-2021-1108.PMC8419622.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39256910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Min Ji Jeon, Won Gu Kim, Tae Yong Kim, Young Kee Shong, Won Bae Kim
{"title":"Active Surveillance as an Effective Management Option for Low-Risk Papillary Thyroid Microcarcinoma.","authors":"Min Ji Jeon, Won Gu Kim, Tae Yong Kim, Young Kee Shong, Won Bae Kim","doi":"10.3803/EnM.2021.1042","DOIUrl":"https://doi.org/10.3803/EnM.2021.1042","url":null,"abstract":"<p><p>Active surveillance (AS) for low-risk papillary thyroid microcarcinoma (PTMC) has been accepted worldwide as safe and effective. Despite the growing acceptance of AS in the management of low-risk PTMCs, there are barriers to AS in real clinical settings, and it is important to understand and establish appropriate AS protocol from initial evaluation to follow-up. PTMC management strategies should be decided upon after careful consideration of patient and tumor characteristics by a multidisciplinary team of thyroid cancer specialists. Patients should understand the risks and benefits of AS, participate in decision-making and follow structured monitoring strategies. In this review, we discuss clinical outcomes of AS from previous studies, optimal indications and follow-up strategies for AS, and unresolved questions about AS.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"717-724"},"PeriodicalIF":3.4,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/76/enm-2021-1042.PMC8419618.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39300864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}