Endocrinology and metabolism (Seoul, Korea)最新文献

{"title":"Continuous Glucose Monitoring in the Hospital.","authors":"M Citlalli Perez-Guzman,&nbsp;Trisha Shang,&nbsp;Jennifer Y Zhang,&nbsp;Donna Jornsay,&nbsp;David C Klonoff","doi":"10.3803/EnM.2021.201","DOIUrl":"https://doi.org/10.3803/EnM.2021.201","url":null,"abstract":"<p><p>Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals. The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. The use of CGMs to automatically and remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease: the amount of necessary nursing exposure to COVID-19 patients with diabetes; the amount of time required for obtaining blood glucose measurements, and the amount of personal protective equipment necessary for interacting with patients during the blood glucose testing. The United States Food and Drug Administration (FDA) is now exercising enforcement discretion and not objecting to certain factory-calibrated CGMs being used in a hospital setting, both to facilitate patient care and to obtain performance data that can be used for future regulatory submissions. CGMs can be used in the hospital to decrease the frequency of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease hypoglycemic episodes. Most of the research on CGMs in the hospital has focused on their accuracy and only recently outcomes data has been reported. A hospital CGM program requires cooperation of physicians, bedside nurses, diabetes educators, and hospital administrators to appropriately select and manage patients. Processes for collecting, reviewing, storing, and responding to CGM data must be established for such a program to be successful. CGM technology is advancing and we expect that CGMs will be increasingly used in the hospital for patients with diabetes.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"240-255"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/ac/enm-2021-201.PMC8090458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25534665","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":"Role of PCSK9 Inhibitors in Patients with Familial Hypercholesterolemia.","authors":"Brian Tomlinson,&nbsp;Nivritti Gajanan Patil,&nbsp;Manson Fok,&nbsp;Christopher Wai Kei Lam","doi":"10.3803/EnM.2021.964","DOIUrl":"https://doi.org/10.3803/EnM.2021.964","url":null,"abstract":"<p><p>Patients with familial hypercholesterolemia (FH) are at high or very high risk for cardiovascular disease. Those with heterozygous FH (HeFH) often do not reach low-density lipoprotein cholesterol (LDL-C) targets with statin and ezetimibe therapy, and those with homozygous FH (HoFH) usually require additional lipid-modifying therapies. Drugs that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) offer a novel approach to reduce LDL-C. The monoclonal antibodies, alirocumab and evolocumab, given by subcutaneous injection every 2 or 4 weeks produce reductions in LDL-C of 50% to 60% in patients with HeFH, allowing many of them to achieve their LDL-C goals. Patients with HoFH show a reduced and more variable LDL-C response, which appears to depend on residual LDL receptor activity, and those with receptor-negative mutations may show no response. Inclisiran is a long-acting small interfering RNA therapeutic agent that inhibits the synthesis of PCSK9. Subcutaneous doses of 300 mg can reduce LDL-C by more than 50% for at least 6 months and the responses in HeFH and HoFH patients are similar to those achieved with monoclonal antibodies. These PCSK9 inhibitors are generally well tolerated and they provide a new opportunity for effective treatment for the majority of patients with FH.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"279-295"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/da/enm-2021-964.PMC8090480.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38884314","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":"New Era for Renal-Protective Therapy in Type 2 Diabetes: Better Renal Outcomes in Patients with Type 2 Diabetes Taking Sodium-Glucose Cotransporter 2 Inhibitors versus Dipeptidyl Peptidase-4 Inhibitors.","authors":"Chan-Hee Jung","doi":"10.3803/EnM.2021.203","DOIUrl":"https://doi.org/10.3803/EnM.2021.203","url":null,"abstract":"Diabetes is the most common cause of chronic kidney disease (CKD) globally. Diabetes and CKD commonly coexist and are associated with a high risk for cardiovascular (CV) morbidity and mortality. Diabetic kidney disease (DKD) is very prevalent, and the proportion of Korean adults >30 years of age with diabetes who had either albuminuria or CKD was found to be over 30% [1]. The global burden of DKD or DM-induced end-stage renal disease (ESRD) has continued unabated even though allcause mortality and CV mortality are generally declining. Until recently, the only treatment with a demonstrated ability to attenuate DKD was a renin-angiotensin system (RAS) blocker. In addition, residual nephropathy risk remained present in patients with type 2 diabetes mellitus (T2DM) despite multifactorial intensive medical therapy, including antihypertensive agents such as RAS blockers [2]. A progressive decline in renal function in CKD patients has been regarded as an inevitable and unstoppable fact. Just a few years ago, no class of glucose-lowering agent was considered to be the preferred treatment. Instead, all glucoselowering medication has been considered equal, with a focus on glucose control rather than end-organ protection and comorbidities. More than 22 randomized controlled trials (RCTs) of dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide receptor agonists (GLP-1RAs), and sodium-glucose cotransporter 2 (SGLT2) inhibitors on CV or kidney outcomes have been completed, resulting in tremendous evidence that has led to major changes in diabetes care in just 10 years [3]. From several CV trials and dedicated kidney outcome trials, SGLT2 inhibitors have already achieved stardom due to their ability to slow the rate of CKD progression and improve renal outcomes in T2DM. Major endocrinology, nephrology, and cardiology clinical practice guidelines are rapidly updating their recommendations to reflect the emerging evidence that SGLT2 inhibitors provide benefits in terms of CV and kidney protection [4-7]. All current guidelines recommend SGLT2 inhibitors for patients with T2DM who have atherosclerotic cardiovascular disease (ASCVD), CKD, and heart failure (HF). In addition, the European Society of Cardiology and the European Association for the Study of Diabetes guidelines recommend SGLT2 inhibitors independent of metformin [5]. SGLT2 inhibitors are even beginning to be used as the first-line therapy in patients with T2DM who have ASCVD, HF, or CKD. Three important RCTs assessed the protective effect of DPP4 inhibitors on renal function. The Saxagliptin Assessment of","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"339-341"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/66/enm-2021-203.PMC8090473.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38939064","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":"Diagnostic Accuracy of Computed Tomography in Predicting Primary Aldosteronism Subtype According to Age.","authors":"Seung Hun Lee,&nbsp;Jong Woo Kim,&nbsp;Hyun-Ki Yoon,&nbsp;Jung-Min Koh,&nbsp;Chan Soo Shin,&nbsp;Sang Wan Kim,&nbsp;Jung Hee Kim","doi":"10.3803/EnM.2020.901","DOIUrl":"https://doi.org/10.3803/EnM.2020.901","url":null,"abstract":"<p><strong>Background: </strong>Guidelines by the Endocrine Society Guideline on bypassing adrenal vein sampling (AVS) in patients <35 years old with marked primary aldosteronism (PA) (hypokalemia and elevated plasma aldosterone concentration [PAC]) and a unilateral lesion on computed tomography (CT) are based on limited number of studies. We aimed to determine the accuracy of CT in PA patients according to age.</p><p><strong>Methods: </strong>In this retrospective study, we investigated the concordance between CT and AVS in 466 PA patients from two tertiary centers who successfully underwent AVS.</p><p><strong>Results: </strong>CT had an overall accuracy of 64.4% (300/466). In the group with unilateral lesion, patients with hypokalemia had higher concordance than those without hypokalemia (85.0% vs. 43.6%, P<0.001). In the group with marked PA (hypokalemia and PAC >15.9 ng/dL) and unilateral lesion, accuracy of CT was 84.6% (11/13) in patients aged <35 years; 100.0% (20/20), aged 35 to 39 years; 89.4% (59/66), aged 40 to 49 years; and 79.8% (79/99), aged ≥50 years. Cut-off age and PAC for concordance was <50 years and >29.6 ng/dL, respectively. The significant difference in accuracy of CT in 198 patients with marked PA and a unilateral lesion between the <50-year age group and ≥50-year age group (90.9% vs. 79.8%, P=0.044) disappeared in 139 of 198 patients with PAC > 30.0 ng/dL (91.9% vs. 87.7%, P=0.590).</p><p><strong>Conclusion: </strong>Patients with hypokalemia, PAC >30.0 ng/dL, and unilateral lesion were at high risk of unilateral PA regardless of age.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"401-412"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/fd/enm-2020-901.PMC8090455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25535608","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":"Gender-Dependent Reference Range of Serum Calcitonin Levels in Healthy Korean Adults.","authors":"Eyun Song,&nbsp;Min Ji Jeon,&nbsp;Hye Jin Yoo,&nbsp;Sung Jin Bae,&nbsp;Tae Yong Kim,&nbsp;Won Bae Kim,&nbsp;Young Kee Shong,&nbsp;Hong-Kyu Kim,&nbsp;Won Gu Kim","doi":"10.3803/EnM.2020.939","DOIUrl":"https://doi.org/10.3803/EnM.2020.939","url":null,"abstract":"<p><strong>Background: </strong>Serum calcitonin measurement contains various clinical and methodological aspects. Its reference level is wide and unclear despite sensitive calcitonin kits are available. This study aimed to identify the specific reference range in the healthy Korean adults.</p><p><strong>Methods: </strong>Subjects were ≥20 years with available calcitonin (measured by a two-site immunoradiometric assay) data by a routine health checkup. Three groups were defined as all eligible subjects (group 1, n=10,566); subjects without self or family history of thyroid disease (group 2, n=5,152); and subjects without chronic kidney disease, autoimmune thyroid disease, medication of proton pump inhibitor/H2 blocker/steroid, or other malignancies (group 3, n=4,638).</p><p><strong>Results: </strong>This study included 6,341 male and 4,225 female subjects. Males had higher mean calcitonin than females (2.3 pg/mL vs. 1.9 pg/mL, P<0.001) in group 1. This gender difference remained similar in groups 2 and 3. Calcitonin according to age or body mass index was not significant in both genders. Higher calcitonin in smoking than nonsmoking men was observed but not in women. Sixty-nine subjects had calcitonin higher than the upper reference limit (10 pg/mL) and 64 of them had factors associated with hypercalcitoninemia besides medullary thyroid cancer. Our study suggests the reference intervals for men who were non, ex-, current smokers, and women (irrespective of smoking status) as <5.7, <7.1, <7.9, and <3.6 pg/mL, respectively.</p><p><strong>Conclusion: </strong>Specific calcitonin reference range should be provided considering for sex and smoking status. Taking account for several factors known to induce hypercalcitoninemia can help interpret the gray zone of moderately elevated calcitonin.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"365-373"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/b6/enm-2020-939.PMC8090475.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25566615","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":"Cardiorenal Protection in Diabetic Kidney Disease.","authors":"Jason F Lee,&nbsp;Ecaterina Berzan,&nbsp;Vikas S Sridhar,&nbsp;Ayodele Odutayo,&nbsp;David Z I Cherney","doi":"10.3803/EnM.2021.987","DOIUrl":"https://doi.org/10.3803/EnM.2021.987","url":null,"abstract":"<p><p>Over the last 5 years there have been many new developments in the management of diabetic kidney disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter-2 (SGLT2) inhibitors were initially used for glycemic control, but more recent studies have now shown that their benefits extend to cardiovascular and kidney outcomes. The recent addition of data on the novel mineralocorticoid receptor antagonist (MRA) gives us another approach to further decrease the residual risk of diabetic kidney disease progression. In this review we describe the mechanism of action, key studies, and possible adverse effects related to these three classes of medications. The management of type 2 diabetes now includes an increasing number of medications for the management of comorbidities in a patient population at significant risk of cardiovascular disease and progression of chronic kidney disease. It is from this perspective that we seek to outline the rationale for the sequential and/or combined use of SGLT2 inhibitors, GLP-1 RA and MRAs in patients with type 2 diabetes for heart and kidney protection.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"256-269"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/6b/enm-2021-987.PMC8090466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38888760","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":"Unilateral Thyroid-Associated Orbitopathy as the Only Sign of Occult Celiac Disease: Effective Treatment with a Gluten-Free Diet.","authors":"Ilaria Stramazzo,&nbsp;Marco Centanni,&nbsp;Camilla Virili","doi":"10.3803/EnM.2021.981","DOIUrl":"https://doi.org/10.3803/EnM.2021.981","url":null,"abstract":"A 36-year-old Caucasian woman presented to our clinic with unilateral orbitopathy. In the previous 3 months, she had noticed that her right eye was “more opened” with irritation, burning, increased tearing, and episodic retrobulbar pain. Her past medical history included only a diagnosis of euthyroid Hashimoto thyroiditis (HT) 13 years before. Examining her previous clinical reports, we detected positivity for anti-transglutaminase antibodies (anti-tTg Ab), which dated back to the time of the diagnosis of HT and had not been further investigated. Since then, she reported a varied diet, regular menstruation, and normal bowel movements. She reported no history of pregnancy, abortions, smoking habit, or allergies. Her only medication was a history of contraceptive pill use for several years. Thyroid ultrasonography showed the typical features of chronic autoimmune thyroiditis, while blood tests confirmed a normal thyroid-stimulating hormone (TSH) level (3.5 mU/L), along with strong positivity for anti-thyroglobulin and anti-thyroperoxidase antibodies (anti-Tg Ab and anti-TPO Ab). A whole-eye examination demonstrated, in the right eye, mild eyelid swelling, mild redness of the conjunctiva, and upper eyelid retraction (eyelid aperture 12 mm vs. 9 mm in the left eye). No sign of orbitopathy was found in the left eye. There was no proptosis (both eyes 18 mm), and visual acuity was normal in the absence of diplopia. On a physical examination, anthropometric parameters were normal (weight 55 kg, height 162 cm, body mass index 21 kg/m), and the patient’s vital signs were also in the normal range. The thyroid was palpable with an increased texture, in the absence of signs of hyperfunction or hypofunction. As expected, anti-TSH receptor antibodies (TRAb) were positive (2.8 times above the upper limit). Orbital magnetic resonance imaging showed mild dacryoadenitis and thickening of the levator palpebrae muscle, restricted to the right orbit. We assessed the patient’s orbitopathy as active according to the Clinical Activity Score (3 points) and mild according to the European Group of Graves’ Orbitopathy classification. Because of the finding of anti-tTg Ab positivity, which had been neglected 13 years before, and the described association between thyroid autoimmunity and celiac disease (CD), we decided to further investigate this possibility, and again obtained an increased concentration of these autoantibodies. Duodenal endoscopy was thus performed, revealing increased intraepithelial lymphocytes, hyperplastic crypts, and severe villous atrophy (Marsh 3c CD). We then confirmed the diagnosis of unilateral and euthyroid thyroid-associated orbitopathy (TAO) in a patient with CD. Therefore, the patient was advised to start a gluten-free diet (GFD) and she agreed. The patient then noticed a progressive improvement of ocular signs and symptoms. Three months later, a blood test revealed that serum TRAb and anti-tTgAb had","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"466-467"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/bc/enm-2021-981.PMC8090460.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38939065","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":"DEHP Down-Regulates Tshr Gene Expression in Rat Thyroid Tissues and FRTL-5 Rat Thyrocytes: A Potential Mechanism of Thyroid Disruption.","authors":"Min Joo Kim,&nbsp;Hwan Hee Kim,&nbsp;Young Shin Song,&nbsp;Ok-Hee Kim,&nbsp;Kyungho Choi,&nbsp;Sujin Kim,&nbsp;Byung-Chul Oh,&nbsp;Young Joo Park","doi":"10.3803/EnM.2020.920","DOIUrl":"https://doi.org/10.3803/EnM.2020.920","url":null,"abstract":"<p><strong>Background: </strong>Di-2-ethylhexyl phthalate (DEHP) is known to disrupt thyroid hormonal status. However, the underlying molecular mechanism of this disruption is unclear. Therefore, we investigated the direct effects of DEHP on the thyroid gland.</p><p><strong>Methods: </strong>DEHP (vehicle, 50 mg/kg, and 500 mg/kg) was administered to Sprague-Dawley rats for 2 weeks. The expression of the thyroid hormone synthesis pathway in rat thyroid tissues was analyzed through RNA sequencing analysis, quantitative reverse transcription-polymerase chain reaction (RT-PCR), and immunohistochemical (IHC) staining. DEHP was treated to FRTL-5 rat thyroid cells, and an RT-PCR analysis was performed. A reporter gene assay containing the promoter of thyroid stimulating hormone receptor (TSHR) in Nthy-ori 3-1 human thyroid cells was constructed, and luciferase activity was determined.</p><p><strong>Results: </strong>After DEHP treatment, the free thyroxine (T4) and total T4 levels in rats significantly decreased. RNA sequencing analysis of rat thyroid tissues showed little difference between vehicle and DEHP groups. In the RT-PCR analysis, Tshr expression was significantly lower in both DEHP groups (50 and 500 mg/kg) compared to that in the vehicle group, and IHC staining showed that TSHR expression in the 50 mg/kg DEHP group significantly decreased. DEHP treatment to FRTL-5 cells significantly down-regulated Tshr expression. DEHP treatment also reduced luciferase activity in a reporter gene assay for TSHR.</p><p><strong>Conclusion: </strong>Although overall genetic changes in the thyroid hormone synthesis pathway are not clear, DEHP exposure could significantly down-regulate Tshr expression in thyroid glands. Down-regulation of Tshr gene appears to be one of potential mechanisms of thyroid disruption by DEHP exposure.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"447-454"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/79/enm-2020-920.PMC8090463.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25534664","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":"Cumulative Exposure to Metabolic Syndrome Components and the Risk of Dementia: A Nationwide Population-Based Study.","authors":"Yunjung Cho,&nbsp;Kyungdo Han,&nbsp;Da Hye Kim,&nbsp;Yong-Moon Park,&nbsp;Kun-Ho Yoon,&nbsp;Mee Kyoung Kim,&nbsp;Seung-Hwan Lee","doi":"10.3803/EnM.2020.935","DOIUrl":"https://doi.org/10.3803/EnM.2020.935","url":null,"abstract":"<p><strong>Background: </strong>Metabolic disturbances are modifiable risk factors for dementia. Because the status of metabolic syndrome (MetS) and its components changes over time, we aimed to investigate the association of the cumulative exposure to MetS and its components with the risk of dementia.</p><p><strong>Methods: </strong>Adults (n=1,492,776; ≥45-years-old) who received health examinations for 4 consecutive years were identified from a nationwide population-based cohort in Korea. Two exposure-weighted scores were calculated: cumulative number of MetS diagnoses (MetS exposure score, range of 0 to 4) and the composite of its five components (MetS component exposure score, range of 0 to 20). Hazard ratio (HR) and 95% confidence interval (CI) values for dementia were analyzed using the multivariable Cox proportional-hazards model.</p><p><strong>Results: </strong>Overall, 47.1% of subjects were diagnosed with MetS at least once, and 11.5% had persistent MetS. During the mean 5.2 years of follow-up, there were 7,341 cases (0.5%) of incident dementia. There was a stepwise increase in the risk of all-cause dementia, Alzheimer's disease, and vascular dementia with increasing MetS exposure score and MetS component exposure score (each P for trend <0.0001). The HR of all-cause dementia was 2.62 (95% CI, 1.87 to 3.68) in subjects with a MetS component exposure score of 20 compared with those with a score of 0. People fulfilling only one MetS component out of 20 already had an approximately 40% increased risk of all-cause dementia and Alzheimer's disease.</p><p><strong>Conclusion: </strong>More cumulative exposure to metabolic disturbances was associated with a higher risk of dementia. Of note, even minimal exposure to MetS components had a significant effect on the risk of dementia.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"424-435"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/76/enm-2020-935.PMC8090478.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25587332","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":"Effect of CCL11 on In Vitro Myogenesis and Its Clinical Relevance for Sarcopenia in Older Adults.","authors":"Da Ae Kim,&nbsp;So Jeong Park,&nbsp;Jin Young Lee,&nbsp;Jeoung Hee Kim,&nbsp;Seungjoo Lee,&nbsp;Eunju Lee,&nbsp;Il-Young Jang,&nbsp;Hee-Won Jung,&nbsp;Jin Hoon Park,&nbsp;Beom-Jun Kim","doi":"10.3803/EnM.2020.942","DOIUrl":"https://doi.org/10.3803/EnM.2020.942","url":null,"abstract":"<p><strong>Background: </strong>The C-C motif chemokine ligand 11 (CCL11) has been receiving attention as a potential pro-aging factor. Accordingly, it may be involved in muscle metabolism and sarcopenia, a key component of aging phenotypes. To clarify this potential, we investigated the effects of CCL11 on in vitro muscle biology and its clinical relevance for sarcopenia parameters in older adults.</p><p><strong>Methods: </strong>Myogenesis was induced in mouse C2C12 myoblasts with 2% horse serum. Human blood samples were collected from 79 participants who underwent a functional assessment. Thereafter, CCL11 level was measured using a quantikine ELISA kit. Sarcopenia was defined using the Asian-specific guideline.</p><p><strong>Results: </strong>Recombinant CCL11 treatment significantly stimulated myogenesis in a dose-dependent manner, and consistently increased the expression of myogenic differentiation markers. Among the C-C chemokine receptors (CCRs), CCR5, not CCR2 and CCR3, was predominantly expressed in muscle cells. Further, the CCR5 inhibitor blocked recombinant CCL11-stimulated myogenesis. In a clinical study, serum CCL11 level was not significantly different according to the status of sarcopenia, low muscle mass, weak muscle strength, and poor physical performance, and was not associated with skeletal muscle index, grip strength, short physical performance battery score, gait speed, and time to complete 5 chair stands, after adjusting for sex, age, and body mass index.</p><p><strong>Conclusion: </strong>Contrary to expectations, CCL11 exerted beneficial effects on muscle metabolism at least in vitro system. However, its impact on human muscle health was not evident, suggesting that circulating CCL11 may not be a useful biomarker for sarcopenia risk assessment in older adults.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"455-465"},"PeriodicalIF":3.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/ca/enm-2020-942.PMC8090464.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25587331","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}