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  • 1
    Online Resource
    Online Resource
    Roles of Follicle-Stimulating Hormone on Bone Metabolism in Late Postmenopausal Women
    Korean Society for Bone and Mineral Research ; 2022
    In:  Journal of Bone Metabolism Vol. 29, No. 3 ( 2022-08-31), p. 175-183
    Details
    In: Journal of Bone Metabolism, Korean Society for Bone and Mineral Research, Vol. 29, No. 3 ( 2022-08-31), p. 175-183
    Abstract: Background: The effects of elevated follicle-stimulating hormone (FSH) levels on physiological changes in the bone remain unclear. This study aimed to clarify the association between FSH concentrations and bone mineral density (BMD) and bone turnover markers (BTM) in late postmenopausal women.Methods: A total of 169 Korean women were enrolled. The participants’ ages ranged from 60 to 84 years (mean age, 69.0±5.1) and reported a mean duration of 19.4±6.6 years since menopause (YSM). The participants showed an average body mass index (BMI) of 24.4±2.8 kg/m2. Age, YSM, estradiol, testosterone, and BMI were confounders in the Pearson's partial correlation. A test for trends across the quartiles of FSH levels was performed for each variable.Results: The mean FSH and estradiol concentrations were 61.5 IU/L and 2.9 pg/mL, respectively. Serum FSH concentration was not significantly associated with BMD (lumbar, r=0.09, P=0.30; total hip, r=0.00, P=0.96; and femoral neck, r=0.05, P=0.62). BTM across the FSH quartiles did not show any trend association (bone-specific alkaline phosphate, P=0.31; crosslinked C-terminal telopeptide of type I collagen, P=0.90). Instead, FSH levels were negatively correlated with BMI (r=-0.34, P=0.00). In the multivariate regression model adjusted for age, testosterone, and estradiol, only BMI showed a negative value across the FSH quartiles (β coefficient -0.11, P=0.00).Conclusions: This study identified that high FSH concentrations were not associated with bone loss or high bone turnover in women in the late postmenopausal period.
    Type of Medium: Online Resource
    ISSN: 2287-6375 , 2287-7029
    URL: Article
    DOI: 10.11005/jbm.2022.29.3.175
    Language: English
    Publisher: Korean Society for Bone and Mineral Research
    Publication Date: 2022
    detail.hit.zdb_id: 2765291-9
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  • 2
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    Differential Diagnosis of Thyrotoxicosis by Machine Learning Models with Laboratory Findings
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 6 ( 2022-06-15), p. 1468-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 6 ( 2022-06-15), p. 1468-
    Abstract: Differential diagnosis of thyrotoxicosis is essential because therapeutic approaches differ based on disease etiology. We aimed to perform differential diagnosis of thyrotoxicosis using machine learning algorithms with initial laboratory findings. This is a retrospective study through medical records. Patients who visited a single hospital for thyrotoxicosis from June 2016 to December 2021 were enrolled. In total, 230 subjects were analyzed: 124 (52.6%) patients had Graves’ disease, 65 (28.3%) suffered from painless thyroiditis, and 41 (17.8%) were diagnosed with subacute thyroiditis. In consideration that results for the thyroid autoantibody test cannot be immediately confirmed, two different models were devised: Model 1 included triiodothyronine (T3), free thyroxine (FT4), T3 to FT4 ratio, erythrocyte sediment rate, and C-reactive protein (CRP); and Model 2 included all Model 1 variables as well as thyroid autoantibody test results, including thyrotropin binding inhibitory immunoglobulin (TBII), thyroid-stimulating immunoglobulin, anti-thyroid peroxidase antibody, and anti-thyroglobulin antibody (TgAb). Differential diagnosis accuracy was calculated using seven machine learning algorithms. In the initial blood test, Graves’ disease was characterized by increased thyroid hormone levels and subacute thyroiditis showing elevated inflammatory markers. The diagnostic accuracy of Model 1 was 65–70%, and Model 2 accuracy was 78–90%. The random forest model had the highest classification accuracy. The significant variables were CRP and T3 in Model 1 and TBII, CRP, and TgAb in Model 2. We suggest monitoring the initial T3 and CRP levels with subsequent confirmation of TBII and TgAb in the differential diagnosis of thyrotoxicosis.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12061468
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662336-5
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  • 3
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    Optimal LDL cholesterol levels in young and old patients with type 2 diabetes for secondary prevention of cardiovascular diseases are different
    Bioscientifica ; 2023
    In:  Endocrine Connections Vol. 12, No. 11 ( 2023-11-01)
    Details
    In: Endocrine Connections, Bioscientifica, Vol. 12, No. 11 ( 2023-11-01)
    Abstract: Real-world-based population data about the optimal low-density lipoprotein cholesterol (LDL-C) level for preventing cardiovascular disease in very high-risk populations is scarce. Methods From 2009 to 2012, 26,922 people aged ≥ 40 years with type 2 diabetes mellitus (T2DM) who had a history of percutaneous coronary intervention (PCI) were analyzed. Data from the Korean National Health Insurance System were used. They were followed up to the date of a cardiovascular event or the time to death, or until December 31, 2018. Endpoints were recurrent PCI, newly stroke or heart failure, cardiovascular death, and all-cause death. Participants were divided into the following categories according to LDL-C level: 〈 55 mg/dL, 55–69 mg/dL, 70–99 mg/dL, 100–129 mg/dL, 130–159 mg/dL, and ≥ 160 mg/dL. Results Compared to LDL-C 〈 55 mg/dL, the hazard ratios (HR) for re-PCI and stroke increased linearly with increasing LDL-C level in the population 〈 65 years. However, in ≥ 65 years old, HRs for re-PCI and stroke in LDL-C = 55–69 mg/dL were 0.97 (95% CI: 0.85–1.11) and 0.96 (95% CI: 0.79–2.23), respectively. The optimal range with the lowest HR for heart failure and all-cause mortality were LDL-C = 70–99 mg/dL and LDL-C = 55–69 mg/dL, respectively, in all age groups (HR: 0.99, 95% CI: 0.91–1.08 and HR: 0.91, 95% CI: 0.81–1.01). Conclusion LDL-C level below 55 mg/dL appears to be optimal in T2DM patients with established cardiovascular disease aged 〈 65 years, while an LDL-C level of 55–69 mg/dL may be optimal for preventing recurrent PCI and stroke in patients over 65 years old.
    Type of Medium: Online Resource
    ISSN: 2049-3614
    URL: Article
    DOI: 10.1530/EC-23-0142
    Language: Unknown
    Publisher: Bioscientifica
    Publication Date: 2023
    detail.hit.zdb_id: 2668428-7
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  • 4
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    Online Resource
    Sodium-glucose cotransporter 2 inhibitors for non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus: A nationwide propensity-score matched cohort study
    Elsevier BV ; 2022
    In:  Diabetes Research and Clinical Practice Vol. 194 ( 2022-12), p. 110187-
    Details
    In: Diabetes Research and Clinical Practice, Elsevier BV, Vol. 194 ( 2022-12), p. 110187-
    Type of Medium: Online Resource
    ISSN: 0168-8227
    URL: Article
    DOI: 10.1016/j.diabres.2022.110187
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2004910-9
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  • 5
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    Repeated Low High-Density Lipoprotein Cholesterol and the Risk of Thyroid Cancer: A Nationwide Population- Based Study in Korea
    Korean Endocrine Society ; 2022
    In:  Endocrinology and Metabolism Vol. 37, No. 2 ( 2022-04-30), p. 303-311
    Details
    In: Endocrinology and Metabolism, Korean Endocrine Society, Vol. 37, No. 2 ( 2022-04-30), p. 303-311
    Abstract: Background: High-density lipoprotein cholesterol (HDL-C) plays an important role in the reverse cholesterol transport pathway and prevents atherosclerosis-mediated disease. It has also been suggested that HDL-C may be a protective factor against cancer. However, an inverse correlation between HDL-C and cancer has not been established, and few studies have explored thyroid cancer.Methods: The study participants received health checkups provided by the Korean National Health Insurance Service from 2009 to 2013 and were followed until 2019. Considering the variability of serum HDL-C level, low HDL-C level was analyzed by grouping based on four consecutive health checkups. The data analysis was performed using univariate and multivariate Cox proportional hazard regression models.Results: A total of 3,134,278 total study participants, thyroid cancer occurred in 16,129. In the crude model, the hazard ratios for the association between repeatedly measured low HDL-C levels and thyroid cancer were 1.243, 1.404, 1.486, and 1.680 (P for trend 〈 0.01), respectively, which were significant even after adjusting for age, sex, lifestyle factors, and metabolic diseases. The subgroup analysis revealed that low HDL-C levels likely had a greater impact on the group of patients with central obesity (P for interaction= 0.062), high blood pressure (P for interaction=0.057), impaired fasting glucose (P for interaction=0.051), and hyperlipidemia (P for interaction=0.126).Conclusion: Repeatedly measured low HDL-C levels can be considered a risk factor for cancer as well as vascular disease. Low HDL-C levels were associated with the risk of thyroid cancer, and this correlation was stronger in a metabolically unhealthy population.
    Type of Medium: Online Resource
    ISSN: 2093-596X , 2093-5978
    URL: Article
    DOI: 10.3803/EnM.2021.1332
    Language: English
    Publisher: Korean Endocrine Society
    Publication Date: 2022
    detail.hit.zdb_id: 2802452-7
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  • 6
    Online Resource
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    Table_1.docx
    Frontiers Media SA ; 2023
    In:  Frontiers in Endocrinology Vol. 14 ( 2023-7-20)
    Details
    In: Frontiers in Endocrinology, Frontiers Media SA, Vol. 14 ( 2023-7-20)
    Abstract: Levothyroxine suppressive therapy following thyroidectomy for thyroid cancer patients is considered as a risk factor for osteoporosis and fragility fractures. We evaluated the association of regular exercise and exercise habit change with fracture risk in adults older than 40 years who underwent thyroidectomy for thyroid cancer. Methods We enrolled the patients who underwent thyroidectomy for thyroid cancer older than 40 years between 2010 and 2016 from the Korean National Health Insurance Service data, and they were followed through 2019. Based on the questionnaire of health examination within 2 years before and after surgery, whether regular exercise once a week was evaluated. The reference group for the statistical analysis was the continuing lack of physical activity group that did not exercise before or after surgery. For fractures newly diagnosed during the follow-up period, univariate and multivariate Cox regression analyses were performed for risk evaluation. Results We evaluated 74,774 subjects, of whom 2,924 (3.9%) experienced any fractures during a median follow-up of 4.5 years. Compared with the group consistently lack of physical activity, the group that exercised before and after surgery showed a significant decrease in the risk of any fracture, vertebral fracture, and hip fracture: adjusted hazard ratio 0.848 (95% Confidence Interval 0.771–0.932), 0.703 (0.591–0.836), and 0.405 (0.224–0.732), respectively. For vertebral fracture, a significant reduction in fracture risk was confirmed even in patients who started their regular exercise after surgery: adjusted hazard ratio 0.779 (0.648–0.936). The risk reduction for vertebral fractures upon the initiation of exercise was found to be significant in the high-risk groups of patients: women and total thyroidectomy patients. Conclusion We suggest that maintaining or starting regular exercise after surgery may help prevent fractures in thyroid cancer patients older than 40 years who have undergone thyroidectomy.
    Type of Medium: Online Resource
    ISSN: 1664-2392
    URL: Article
    URL: Article
    DOI: 10.3389/fendo.2023.1173781
    DOI: 10.3389/fendo.2023.1173781.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2592084-4
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  • 7
    Online Resource
    Online Resource
    Bone mineral density and lipid profiles in older adults: a nationwide cross-sectional study
    Springer Science and Business Media LLC ; 2023
    In:  Osteoporosis International Vol. 34, No. 1 ( 2023-01), p. 119-128
    Details
    In: Osteoporosis International, Springer Science and Business Media LLC, Vol. 34, No. 1 ( 2023-01), p. 119-128
    Type of Medium: Online Resource
    ISSN: 0937-941X , 1433-2965
    URL: Article
    DOI: 10.1007/s00198-022-06571-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1480645-9
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  • 8
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    Cumulative exposure to metabolic syndrome increases thyroid cancer risk in young adults: a population-based cohort study
    Korean Association of Internal Medicine ; 2023
    In:  The Korean Journal of Internal Medicine Vol. 38, No. 4 ( 2023-07-01), p. 526-533
    Details
    In: The Korean Journal of Internal Medicine, Korean Association of Internal Medicine, Vol. 38, No. 4 ( 2023-07-01), p. 526-533
    Abstract: Background/Aims: A re-increasing trend of thyroid cancer since 2015 has been observed despite a similar examination rate, and the incidence of thyroid cancer among young adults continues to rise.Methods: This study used data from the Korean National Health Insurance Service. Individuals 20–39 years of age who underwent ≥ 4 health checkups from 2009–2013 were enrolled and followed throughout 2019. To quantify the metabolic burden, groups were divided by the number of diagnoses of metabolic syndrome across four consecutive health examinations.Results: Among the study population (n = 1,204,646), 5,929 (0.5%) were diagnosed with thyroid cancer during a follow- up period of 5 years. The hazard ratio (95% confidence interval) values of thyroid cancer occurrence according to the number (1–4) of diagnoses of metabolic syndrome across the four health examinations compared to the group without metabolic syndrome were significantly greater, as follows: 1.12 (1.02–1.23), 1.25 (1.10–1.42), 1.33 (1.15–1.55), and 1.48 (1.25–1.75) (p for trend 〈 0.01), respectively. Each component of metabolic syndrome showed a significant increase in hazard ratio according to the number of diagnoses except for impaired fasting glucose criteria.Conclusions: Cumulative exposure to metabolic syndrome was associated with thyroid cancer risk in young adults.
    Type of Medium: Online Resource
    ISSN: 1226-3303 , 2005-6648
    URL: Article
    DOI: 10.3904/kjim.2022.405
    Language: English
    Publisher: Korean Association of Internal Medicine
    Publication Date: 2023
    detail.hit.zdb_id: 2500508-X
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  • 9
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    Online Resource
    The efficacy of denosumab in Korean male patients with osteoporosis
    Korean Association of Internal Medicine ; 2022
    In:  The Korean Journal of Internal Medicine Vol. 37, No. 5 ( 2022-09-01), p. 1011-1020
    Details
    In: The Korean Journal of Internal Medicine, Korean Association of Internal Medicine, Vol. 37, No. 5 ( 2022-09-01), p. 1011-1020
    Abstract: Background/Aims: Despite the prominence of denosumab as the number one prescribed anti-osteoporosis drug in Korea, the effects of denosumab in male osteoporosis patients were not researched sufficiently. Moreover, concerns on rebound vertebral fractures associated with poor denosumab adherence exist.Methods: We retrospectively evaluated 147 Korean male osteoporosis patients treated with denosumab. After 12 months of treatment, 60 patients were lost during follow-up, and eight were excluded due to missing data. Out of the initial 147 patients, 79 were considered eligible for the analysis of the efficacy of denosumab. 54 patients were initially drug-naïve, and 25 had previously received bisphosphonate therapy.Results: In 54 drug-naïve patients, significant increases in bone mineral density (BMD) were observed in all measurement sites: 5.2% ± 3.7% in the lumbar spine, 2.3% ± 2.8% in the femoral neck, and 1.9% ± 2.8% in the total hip (p 〈 0.01, respectively). Trabecular bone score showed an increase of 0.5% ± 5.8% in drug-naïve patients. Likewise, in 25 patients with previous bisphosphonate treatment, increase in BMD were observed as well: 4.8% ± 3.5% in the lumbar spine, 1.4% ± 3.6% in the femoral neck, and 0.8% ± 2.1% in the total hip (p 〈 0.01, p = 0.06, p = 0.06, respectively). Significant declines of –55.1% ± 31.8% in C-terminal telopeptide of type 1 collagen (CTX), and –62.9% ± 21.3% in total procollagen 1 N-terminal propeptide (P1NP), in drug-naïve patients; and –37.7% ± 41.5%, in CTX and –55.4% ± 30.1%, in P1NP in patients with previous bisphosphonate treatment were exhibited after 12 months of treatment. The adherence rates of the second and third dosing schedules were 79.9% and 56.8%, respectively.Conclusions: Our study indicates that denosumab is effective in increasing BMD in Korean osteoporosis males regardless of prior bisphosphonate treatment.
    Type of Medium: Online Resource
    ISSN: 1226-3303 , 2005-6648
    URL: Article
    DOI: 10.3904/kjim.2022.064
    Language: English
    Publisher: Korean Association of Internal Medicine
    Publication Date: 2022
    detail.hit.zdb_id: 2500508-X
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  • 10
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    Persistence with Denosumab in Male Osteoporosis Patients: A Real-World, Non-Interventional Multicenter Study
    Korean Endocrine Society ; 2023
    In:  Endocrinology and Metabolism Vol. 38, No. 2 ( 2023-04-30), p. 260-268
    Details
    In: Endocrinology and Metabolism, Korean Endocrine Society, Vol. 38, No. 2 ( 2023-04-30), p. 260-268
    Abstract: Background: Persistence with denosumab in male patients has not been adequately investigated, although poor denosumab persistence is associated with a significant risk of rebound vertebral fractures.Methods: We retrospectively evaluated 294 Korean male osteoporosis patients treated with denosumab at three medical centers and examined their persistence with four doses of denosumab injection over 24 months of treatment. Persistence was defined as the extent to which a patient adhered to denosumab treatment in terms of the prescribed interval and dose, with a permissible gap of 8 weeks. For patients who missed their scheduled treatment appointment(s) during the follow-up period (i.e., no-shows), Cox proportional regression analysis was conducted to explore the factors associated with poor adherence. Several factors were considered, such as age, prior anti-osteoporotic drug use, the treatment provider’s medical specialty, the proximity to the medical center, and financial burdens of treatment.Results: Out of 294 male patients, 77 (26.2%) completed all four sequential rounds of the denosumab treatment. Out of 217 patients who did not complete the denosumab treatment, 138 (63.6%) missed the scheduled treatment(s). Missing treatment was significantly associated with age (odds ratio [OR], 1.03), prior bisphosphonate use (OR, 0.76), and prescription by non-endocrinologists (OR, 2.24). Denosumab was stopped in 44 (20.3%) patients due to medical errors, in 24 (11.1%) patients due to a T-score improvement over –2.5, and in five (2.3%) patients due to expected dental procedures.Conclusion: Our study showed that only one-fourth of Korean male osteoporosis patients were fully adherent to 24 months of denosumab treatment.
    Type of Medium: Online Resource
    ISSN: 2093-596X , 2093-5978
    URL: Article
    DOI: 10.3803/EnM.2023.1663
    Language: English
    Publisher: Korean Endocrine Society
    Publication Date: 2023
    detail.hit.zdb_id: 2802452-7
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