Futoshi Ebara, Masayuki Domichi, A. Suganuma, N. Sakane
Background: The aim of the study is to compare the effect of metformin hydrochloride and alogliptin benzoate combination tablets medication once daily am/pm on blood glucose and investigate predictive factors for drug responses. Methods: This is a single-center, single-dose, open-label, randomized, two-treatment (once-daily, am and pm), two-sequence and two-period crossover study with a washout period of 1 day. Glycemic variability and control were assessed using the FreeStyle Libre Pro continuous glucose monitoring in terms of time spent in different glycemic ranges and low/high blood glucose indices (LBGI/HBGI), and compared between the dosing timing. Results: The average postprandial glucose in lunch and dinner in AM group were lower but not significant compared to PM group. There was no difference in average, time above range (TAR: > 180 mg/dL), time in range (TIR: 70 - 180 mg/dL), time below range (TBR: < 70 mg/dL), and area under curve (AUC) (AM0 - AM6, AM6 - PM0, PM0 - PM6, and PM6 - PM12) between treatments time (AM vs. PM). There was a significant strong negative correlation between high-density lipoprotein cholesterol (HDL-C) levels and changes of HBGI from AM to PM (r = -0.608), but HDL-C levels were not associated with LBGI. There was moderately strong correlation between evening type in chronotype and changes of HBGI from AM to PM (r = 0.592). Conclusions: These findings suggest that HDL-C levels and chronotype might modulate drug response, although there was no difference in average, TIR, TBR, TAR, and AUC between treatments timing in patients with type 2 diabetes (T2D). J Endocrinol Metab. 2021;11(1):8-13 doi: https://doi.org/10.14740/jem720
{"title":"Comparison of Metformin and Alogliptin Fixed-Dose Tablets Once a Morning Versus Once an Evening Using Continuous Glucose Monitoring (AMPM Study): An Open-Label Randomized Cross-Over Trial","authors":"Futoshi Ebara, Masayuki Domichi, A. Suganuma, N. Sakane","doi":"10.14740/JEM.V0I0.720","DOIUrl":"https://doi.org/10.14740/JEM.V0I0.720","url":null,"abstract":"Background: The aim of the study is to compare the effect of metformin hydrochloride and alogliptin benzoate combination tablets medication once daily am/pm on blood glucose and investigate predictive factors for drug responses. Methods: This is a single-center, single-dose, open-label, randomized, two-treatment (once-daily, am and pm), two-sequence and two-period crossover study with a washout period of 1 day. Glycemic variability and control were assessed using the FreeStyle Libre Pro continuous glucose monitoring in terms of time spent in different glycemic ranges and low/high blood glucose indices (LBGI/HBGI), and compared between the dosing timing. Results: The average postprandial glucose in lunch and dinner in AM group were lower but not significant compared to PM group. There was no difference in average, time above range (TAR: > 180 mg/dL), time in range (TIR: 70 - 180 mg/dL), time below range (TBR: < 70 mg/dL), and area under curve (AUC) (AM0 - AM6, AM6 - PM0, PM0 - PM6, and PM6 - PM12) between treatments time (AM vs. PM). There was a significant strong negative correlation between high-density lipoprotein cholesterol (HDL-C) levels and changes of HBGI from AM to PM (r = -0.608), but HDL-C levels were not associated with LBGI. There was moderately strong correlation between evening type in chronotype and changes of HBGI from AM to PM (r = 0.592). Conclusions: These findings suggest that HDL-C levels and chronotype might modulate drug response, although there was no difference in average, TIR, TBR, TAR, and AUC between treatments timing in patients with type 2 diabetes (T2D). J Endocrinol Metab. 2021;11(1):8-13 doi: https://doi.org/10.14740/jem720","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47518696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bhavana Mastebhakti, S. Garg, N. Gupta, Sapna Singh, S. Aggarwal, Ranvijay Singh
Background: Epicardial adipose tissue (EAT) is a distinct visceral adipose tissue that is present in between the visceral pericardium and myocardium, in which the coronary arteries are lodged. This tissue releases several inflammatory and atherogenic mediators which lead to the initiation and/or progression of coronary atherosclerosis and its thickness is related to the presence and severity of atherosclerotic coronary artery disease (CAD). In this study, we aimed to evaluate the EAT thickness in type 2 diabetes mellitus (T2DM) patients by non-contrast computed tomography (NCCT) of the chest and to correlate its value with HbA1c levels, duration of T2DM and carotid intima-media thickness (CIMT). Methods: This was a cross-sectional study comprising of 40 patients with T2DM who underwent NCCT of chest and ultrasonographic estimation of CIMT. Ten individuals with equivalent age and sex were included as controls, in whom NCCT of chest was done for other purposes. All the individuals underwent thorough history, clinical examination and certain investigations based on a predesigned proforma. Results: The EAT thickness was significantly increased in patients with T2DM as compared to controls (8.7 ± 2.94 mm vs. 3.48 ± 0.99 mm, P < 0.001) and also strongly correlated with duration of diabetes (P = 0.02), HbA1c (P is less than or equal to 0.001), total cholesterol (P is less than or equal 0.001), serum triglyceride levels (P is less than or equal 0.001) and body mass index (BMI) (P is less than or equal 0.001). Conclusion: EAT thickness can be regarded as a sensitive and non-invasive marker for risk stratification of CAD. J Endocrinol Metab. 2020;10(6):173-181 doi: https://doi.org/10.14740/jem710
{"title":"Epicardial Adipose Tissue Thickness as a Reliable Marker of Increased Cardiovascular Risk in Patients With Type 2 Diabetes Mellitus","authors":"Bhavana Mastebhakti, S. Garg, N. Gupta, Sapna Singh, S. Aggarwal, Ranvijay Singh","doi":"10.14740/jem710","DOIUrl":"https://doi.org/10.14740/jem710","url":null,"abstract":"Background: Epicardial adipose tissue (EAT) is a distinct visceral adipose tissue that is present in between the visceral pericardium and myocardium, in which the coronary arteries are lodged. This tissue releases several inflammatory and atherogenic mediators which lead to the initiation and/or progression of coronary atherosclerosis and its thickness is related to the presence and severity of atherosclerotic coronary artery disease (CAD). In this study, we aimed to evaluate the EAT thickness in type 2 diabetes mellitus (T2DM) patients by non-contrast computed tomography (NCCT) of the chest and to correlate its value with HbA1c levels, duration of T2DM and carotid intima-media thickness (CIMT). Methods: This was a cross-sectional study comprising of 40 patients with T2DM who underwent NCCT of chest and ultrasonographic estimation of CIMT. Ten individuals with equivalent age and sex were included as controls, in whom NCCT of chest was done for other purposes. All the individuals underwent thorough history, clinical examination and certain investigations based on a predesigned proforma. Results: The EAT thickness was significantly increased in patients with T2DM as compared to controls (8.7 ± 2.94 mm vs. 3.48 ± 0.99 mm, P < 0.001) and also strongly correlated with duration of diabetes (P = 0.02), HbA1c (P is less than or equal to 0.001), total cholesterol (P is less than or equal 0.001), serum triglyceride levels (P is less than or equal 0.001) and body mass index (BMI) (P is less than or equal 0.001). Conclusion: EAT thickness can be regarded as a sensitive and non-invasive marker for risk stratification of CAD. J Endocrinol Metab. 2020;10(6):173-181 doi: https://doi.org/10.14740/jem710","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49501540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kusunoki, N. Wakazono, K. Tsutsumi, Y. Oshida, Tesuro Miyata
Background: We additionally administered selective inhibitor of sodium glucose co-transporter-2 (SGLT2) inhibitor to type 2 diabetic patients on alpha-glucosidase inhibitor (alpha-GI) and/or thiazolidinedione (TZD), to determine whether the multi-drug combination therapy including SGLT2 inhibitor further improved the glycemic control in Japanese patients with diabetes mellitus. Methods: The subjects were divided into four groups. Group I was administered an SGLT2 inhibitor in addition to ongoing treatment using hypoglycemic agents other than alpha-GI and SGLT2 inhibitor. Group II was administered an SGLT2 inhibitor in addition to an alpha-GI. Group III was administered an SGLT2 inhibitor in addition to a TZD. Group IV was administered an SGLT2 inhibitor in addition to an alpha-GI and TZD. The body weight and biochemical parameters were measured before and 1, 2 and 3 years after the start of SGLT2 inhibitor treatment. Results: In patients receiving alpha-GI or TZD, additional administration of an SGLT2 inhibitor resulted in a reduction of the body weight, body mass index (BMI) and serum uric acid level, but had little effect on the glucose or lipid metabolism. On the other hand, additional administration of SGLT2 inhibitor in patients receiving both alpha-GI and TZD (three-drug combination therapy) resulted not only in a reduction of the body weight, BMI and serum uric acid, but also in improvement of the glucose and lipid metabolism, with a reduction of the hemoglobin A1c level and increase of the serum high-density lipoprotein cholesterol level. Conclusion: The results suggest that three-drug combination therapy with alpha-GI, TZD and SGLT2 inhibitor, each of which has different mechanism of action, is beneficial for the treatment of type 2 diabetes mellitus. J Endocrinol Metab. 2020;10(6):167-172 doi: https://doi.org/10.14740/jem708
{"title":"Combination Therapy of Alpha-Glucosidase Inhibitor, Thiazolidinedione and Sodium Glucose Co-Transporter-2 Inhibitor in Japanese Type 2 Diabetes Patients","authors":"M. Kusunoki, N. Wakazono, K. Tsutsumi, Y. Oshida, Tesuro Miyata","doi":"10.14740/jem708","DOIUrl":"https://doi.org/10.14740/jem708","url":null,"abstract":"Background: We additionally administered selective inhibitor of sodium glucose co-transporter-2 (SGLT2) inhibitor to type 2 diabetic patients on alpha-glucosidase inhibitor (alpha-GI) and/or thiazolidinedione (TZD), to determine whether the multi-drug combination therapy including SGLT2 inhibitor further improved the glycemic control in Japanese patients with diabetes mellitus. Methods: The subjects were divided into four groups. Group I was administered an SGLT2 inhibitor in addition to ongoing treatment using hypoglycemic agents other than alpha-GI and SGLT2 inhibitor. Group II was administered an SGLT2 inhibitor in addition to an alpha-GI. Group III was administered an SGLT2 inhibitor in addition to a TZD. Group IV was administered an SGLT2 inhibitor in addition to an alpha-GI and TZD. The body weight and biochemical parameters were measured before and 1, 2 and 3 years after the start of SGLT2 inhibitor treatment. Results: In patients receiving alpha-GI or TZD, additional administration of an SGLT2 inhibitor resulted in a reduction of the body weight, body mass index (BMI) and serum uric acid level, but had little effect on the glucose or lipid metabolism. On the other hand, additional administration of SGLT2 inhibitor in patients receiving both alpha-GI and TZD (three-drug combination therapy) resulted not only in a reduction of the body weight, BMI and serum uric acid, but also in improvement of the glucose and lipid metabolism, with a reduction of the hemoglobin A1c level and increase of the serum high-density lipoprotein cholesterol level. Conclusion: The results suggest that three-drug combination therapy with alpha-GI, TZD and SGLT2 inhibitor, each of which has different mechanism of action, is beneficial for the treatment of type 2 diabetes mellitus. J Endocrinol Metab. 2020;10(6):167-172 doi: https://doi.org/10.14740/jem708","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43548093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sharifah Faradila Wan Muhamad Hatta, R. Daly, C. Chacko, R. Raghavan
Adrenocortical carcinoma (ACC) is rare with an incidence of 0.7 - 2.0 per million per year. Approximately 60% of cases present with hypercortisolism, and rapidly progressing Cushing’s syndrome with or without virilisation is the most frequent presentation of ACC. Surgical intervention, aimed at removing the tumor and the source of cortisol or adrenocorticotropic hormone (ACTH), is the optimal treatment in most cases of Cushing’s syndrome. However, in hypercortisolemic states, surgical intervention has high rates of perioperative mortality and morbidity. Oral adrenal steroidogenesis inhibitors are commonly used, but in some cases they may not be tolerated or may not act quickly enough to bring down the cortisol level prior to surgery. Hence, occasionally, a more potent, immediate acting, parental agent, e.g., etomidate is necessary. We describe a case of ACC producing cortisol, which was complicated by an acute psychotic episode requiring intravenous etomidate for stabilization of the clinical condition prior to surgery. J Endocrinol Metab. 2020;10(6):190-194 doi: https://doi.org/10.14740/jem682
{"title":"A Case of Etomidate Use in Management of Adrenocortical Carcinoma With Hypercortisolemia","authors":"Sharifah Faradila Wan Muhamad Hatta, R. Daly, C. Chacko, R. Raghavan","doi":"10.14740/jem682","DOIUrl":"https://doi.org/10.14740/jem682","url":null,"abstract":"Adrenocortical carcinoma (ACC) is rare with an incidence of 0.7 - 2.0 per million per year. Approximately 60% of cases present with hypercortisolism, and rapidly progressing Cushing’s syndrome with or without virilisation is the most frequent presentation of ACC. Surgical intervention, aimed at removing the tumor and the source of cortisol or adrenocorticotropic hormone (ACTH), is the optimal treatment in most cases of Cushing’s syndrome. However, in hypercortisolemic states, surgical intervention has high rates of perioperative mortality and morbidity. Oral adrenal steroidogenesis inhibitors are commonly used, but in some cases they may not be tolerated or may not act quickly enough to bring down the cortisol level prior to surgery. Hence, occasionally, a more potent, immediate acting, parental agent, e.g., etomidate is necessary. We describe a case of ACC producing cortisol, which was complicated by an acute psychotic episode requiring intravenous etomidate for stabilization of the clinical condition prior to surgery. J Endocrinol Metab. 2020;10(6):190-194 doi: https://doi.org/10.14740/jem682","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41656107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Garla, S. Gosi, Sravanthi Palakodety, S. Kanduri, K. Kovvuru, Manasa Gunturu, L. Lien
Giant prolactinomas are rare and constitute only 2-3% of prolactinomas. They are defined as prolactinomas greater than 4 cm in size with a prolactin level of > 1,000 µg/L. Unlike prolactinomas, giant prolactinomas have a male preponderance and present a decade earlier in men as compared to women. Giant prolactinomas may present with galactorrhea, irregular periods or decreased libido. Due to their large size, they can involve surrounding brain structures and may present with hydrocephalus, dizziness, seizures, deafness, and cognitive dysfunction. Laboratory assessment may reveal a falsely low prolactin level secondary to “hook effect” which is due to saturation of the capture and detection antibodies used in the assay. Dilution of the sample would show a paradoxical increase in prolactin levels confirming the hook effect. Magnetic resonance imaging (MRI) is warranted to assess the extent of the tumor. Dopamine agonists are the treatment of choice in giant prolactinomas and lead to rapid resolution of symptoms, normalization of prolactin levels, and reduction in the size of the tumors. Refractory giant prolactinomas may be treated with surgery, temozolomide or radiotherapy. Giant prolactinomas can pose unique diagnostic and management challenges because of atypical presentations and confounding laboratory assessments. We present four cases of giant prolactinomas each presenting in a unique manner and discuss the diagnostic and management dilemmas associated with them. J Endocrinol Metab. 2020;10(6):182-189 doi: https://doi.org/10.14740/jem652
{"title":"Giant Prolactinomas: Case Series and Review of the Literature","authors":"V. Garla, S. Gosi, Sravanthi Palakodety, S. Kanduri, K. Kovvuru, Manasa Gunturu, L. Lien","doi":"10.14740/jem652","DOIUrl":"https://doi.org/10.14740/jem652","url":null,"abstract":"Giant prolactinomas are rare and constitute only 2-3% of prolactinomas. They are defined as prolactinomas greater than 4 cm in size with a prolactin level of > 1,000 µg/L. Unlike prolactinomas, giant prolactinomas have a male preponderance and present a decade earlier in men as compared to women. Giant prolactinomas may present with galactorrhea, irregular periods or decreased libido. Due to their large size, they can involve surrounding brain structures and may present with hydrocephalus, dizziness, seizures, deafness, and cognitive dysfunction. Laboratory assessment may reveal a falsely low prolactin level secondary to “hook effect” which is due to saturation of the capture and detection antibodies used in the assay. Dilution of the sample would show a paradoxical increase in prolactin levels confirming the hook effect. Magnetic resonance imaging (MRI) is warranted to assess the extent of the tumor. Dopamine agonists are the treatment of choice in giant prolactinomas and lead to rapid resolution of symptoms, normalization of prolactin levels, and reduction in the size of the tumors. Refractory giant prolactinomas may be treated with surgery, temozolomide or radiotherapy. Giant prolactinomas can pose unique diagnostic and management challenges because of atypical presentations and confounding laboratory assessments. We present four cases of giant prolactinomas each presenting in a unique manner and discuss the diagnostic and management dilemmas associated with them. J Endocrinol Metab. 2020;10(6):182-189 doi: https://doi.org/10.14740/jem652","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49307789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rohan Sadera, J. Youssef, Azza Ramadan, Mohamed H. Ahmed
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that has spread to almost all countries worldwide. Diabetes mellitus (DM) has been shown to increase the risk of COVID-19 disease severity. In this review, we provide a summary of the impact of COIVD-19 on diabetes management and related services. We searched the literature using the following databases: PubMed, Medline, Scopus and Google Scholar. These databases were searched using the keywords: COVID-19, diabetes type 1 and type 2. Lockdown causing social isolation and psychological issues, showed an influence on poor glycemic control amongst people with diabetes. Hence, the use of telemedicine and various technologies in the management of diabetes has substantially increased. In individuals with COVID-19, the current practice is not in favor of using sodium-glucose cotransporter 2 (SGLT2) inhibitors. Furthermore, insulin is recommended for the management of diabetes in critically ill patients. The COVID-19 pandemic was associated with many changes in diabetes management and the delivery of diabetes services. J Endocrinol Metab. 2020;10(6):155-161 doi: https://doi.org/10.14740/jem699
{"title":"What Are the Changes and Burden Associated With COVID-19 in Diabetes Management and Delivery of the Diabetes Services?","authors":"Rohan Sadera, J. Youssef, Azza Ramadan, Mohamed H. Ahmed","doi":"10.14740/jem699","DOIUrl":"https://doi.org/10.14740/jem699","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that has spread to almost all countries worldwide. Diabetes mellitus (DM) has been shown to increase the risk of COVID-19 disease severity. In this review, we provide a summary of the impact of COIVD-19 on diabetes management and related services. We searched the literature using the following databases: PubMed, Medline, Scopus and Google Scholar. These databases were searched using the keywords: COVID-19, diabetes type 1 and type 2. Lockdown causing social isolation and psychological issues, showed an influence on poor glycemic control amongst people with diabetes. Hence, the use of telemedicine and various technologies in the management of diabetes has substantially increased. In individuals with COVID-19, the current practice is not in favor of using sodium-glucose cotransporter 2 (SGLT2) inhibitors. Furthermore, insulin is recommended for the management of diabetes in critically ill patients. The COVID-19 pandemic was associated with many changes in diabetes management and the delivery of diabetes services. J Endocrinol Metab. 2020;10(6):155-161 doi: https://doi.org/10.14740/jem699","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41377565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-alcoholic fatty liver disease (NAFLD) commonly causes an increase in the transaminase levels with the underlying problems, including diabetes, obesity, or both. NAFLD patients are often at an increased risk of cardiovascular events globally, representing a leading cause of death. Therefore, this study aims to review present evidence regarding the utilization of statin in NAFLD patients and discuss the effects of these agents on liver histology and cardiovascular disease. We comprehensively reviewed the current evidence on the statins’ safety in NAFLD patients and their effects on cardiovascular events or liver histology. The findings suggest that statins are safe to be administered to NAFLD patients including people with increased transaminase (< 3 times - upper limit of normal). The reviewed studies indicate that statins may reduce cardiovascular risk. Some controversial data also emerged from the literature regarding the effect of statins on liver histology in NAFLD patients. The treatment with statins is safe, which may also lessen cardiovascular events in patients with NAFLD. Future and ongoing studies will elucidate if statins have a role in treating NAFLD. Although clinicians are often refrained from prescribing statins for NAFLD patients, it is used to reduce cardiovascular mortality and morbidity and lower liver enzymes. J Endocrinol Metab. 2020;000(000):000-000 doi: https://doi.org/10.14740/jem705
{"title":"Statins for Patients With Non-Alcoholic Fatty Liver Disease","authors":"Talal Alghamdi","doi":"10.14740/jem705","DOIUrl":"https://doi.org/10.14740/jem705","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) commonly causes an increase in the transaminase levels with the underlying problems, including diabetes, obesity, or both. NAFLD patients are often at an increased risk of cardiovascular events globally, representing a leading cause of death. Therefore, this study aims to review present evidence regarding the utilization of statin in NAFLD patients and discuss the effects of these agents on liver histology and cardiovascular disease. We comprehensively reviewed the current evidence on the statins’ safety in NAFLD patients and their effects on cardiovascular events or liver histology. The findings suggest that statins are safe to be administered to NAFLD patients including people with increased transaminase (< 3 times - upper limit of normal). The reviewed studies indicate that statins may reduce cardiovascular risk. Some controversial data also emerged from the literature regarding the effect of statins on liver histology in NAFLD patients. The treatment with statins is safe, which may also lessen cardiovascular events in patients with NAFLD. Future and ongoing studies will elucidate if statins have a role in treating NAFLD. Although clinicians are often refrained from prescribing statins for NAFLD patients, it is used to reduce cardiovascular mortality and morbidity and lower liver enzymes. J Endocrinol Metab. 2020;000(000):000-000 doi: https://doi.org/10.14740/jem705","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44723716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Tsygankova, A. G. Antipenko, N. Evdokimova, Ludmila D. Latyntseva, S. S. Bairamova, T. Batluk
This article describes a clinical observation of a patient with a progressive course of malignant metastatic insulinoma, despite repeated embolization and chemoembolization (CE) of the right and left hepatic arteries with doxorubicin and gemcitabine, with metastatic liver lesion and subsequent increase in the size of secondary foci. The key clinical problem was severe recurrent hypoglycemia, which persisted against the background of massive intravenous (IV) glucose infusions, short-acting somatostatin therapy, and subcutaneous (SC) glucagon injections, which not only was an impediment to the pathogenic cytostatic therapy but also has led to the fatal outcome of the patient. J Endocrinol Metab. 2020;10(5):140-143 doi: https://doi.org/10.14740/jem666
{"title":"Difficulties in Correction of Recurrent Hypoglycemia in a Patient With a Progressive Course of Malignant Metastatic Insulinoma","authors":"O. Tsygankova, A. G. Antipenko, N. Evdokimova, Ludmila D. Latyntseva, S. S. Bairamova, T. Batluk","doi":"10.14740/jem666","DOIUrl":"https://doi.org/10.14740/jem666","url":null,"abstract":"This article describes a clinical observation of a patient with a progressive course of malignant metastatic insulinoma, despite repeated embolization and chemoembolization (CE) of the right and left hepatic arteries with doxorubicin and gemcitabine, with metastatic liver lesion and subsequent increase in the size of secondary foci. The key clinical problem was severe recurrent hypoglycemia, which persisted against the background of massive intravenous (IV) glucose infusions, short-acting somatostatin therapy, and subcutaneous (SC) glucagon injections, which not only was an impediment to the pathogenic cytostatic therapy but also has led to the fatal outcome of the patient. J Endocrinol Metab. 2020;10(5):140-143 doi: https://doi.org/10.14740/jem666","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44482979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Kakuma, Yuichi Yoshida, M. Okamoto, H. Shibata, Takashi Tsutsumi, Yoshikuni Kudo
Background: In addition to daily weight measurements and regular exercise, not skipping breakfast, refraining from eating at night, and not overconsuming soft drinks have been reported to suppress the onset and progression of obesity and metabolic syndrome in adulthood. However, few studies have examined the associations between these daily lifestyle habits and the types of eating behaviors (e.g., food preferences, conception of eating, eating habits) among university students. Methods: We investigated the characteristics of eating behaviors based on backgrounds and lifestyle factors in association with changes in weight and metabolism using blood sampling data, a questionnaire on eating behaviors conducted during clinical training, and data from regular health examinations of 100 fifth-grade students at the Oita University Faculty of Medicine in Japan. Results: Characteristic eating behaviors, including daily self-weighing, regular exercise, skipping breakfast, frequently eating late at night, and excess soft drink consumption, were observed for each lifestyle. In addition, three eating behaviors (fast eating, eating late-night snacks, and not eating breakfast) were extracted as factors that cause weight gain of 3% or more from the weight at the time of admission to university. Self-awareness of fast eating was significantly associated with higher body mass index in the fifth grade (P < 0.001), and systolic blood pressure and fasting plasma glucose tended to be higher in students who were strongly aware that they would not have breakfast (P = 0.071 and P = 0.053, respectively). Conclusions: The results indicated that the habits of “fast eating” and “not eating breakfast” respectively increase weight and may cause metabolic disorders, regardless of current weight. Thus, it is important for students to be self-aware of unhealthy eating behaviors in daily life. Although it was developed for the medical treatment of obese patients, the questionnaire on eating behaviors may be useful for helping university students learn eating behavior habits and peculiarities as well as health education. J Endocrinol Metab. 2020;10(5):131-139 doi: https://doi.org/10.14740/jem687
{"title":"Effects of Self-Awareness of Eating Behaviors and Differences in Daily Habits Among Japanese University Students on Changes in Weight and Metabolism","authors":"T. Kakuma, Yuichi Yoshida, M. Okamoto, H. Shibata, Takashi Tsutsumi, Yoshikuni Kudo","doi":"10.14740/jem687","DOIUrl":"https://doi.org/10.14740/jem687","url":null,"abstract":"Background: In addition to daily weight measurements and regular exercise, not skipping breakfast, refraining from eating at night, and not overconsuming soft drinks have been reported to suppress the onset and progression of obesity and metabolic syndrome in adulthood. However, few studies have examined the associations between these daily lifestyle habits and the types of eating behaviors (e.g., food preferences, conception of eating, eating habits) among university students. Methods: We investigated the characteristics of eating behaviors based on backgrounds and lifestyle factors in association with changes in weight and metabolism using blood sampling data, a questionnaire on eating behaviors conducted during clinical training, and data from regular health examinations of 100 fifth-grade students at the Oita University Faculty of Medicine in Japan. Results: Characteristic eating behaviors, including daily self-weighing, regular exercise, skipping breakfast, frequently eating late at night, and excess soft drink consumption, were observed for each lifestyle. In addition, three eating behaviors (fast eating, eating late-night snacks, and not eating breakfast) were extracted as factors that cause weight gain of 3% or more from the weight at the time of admission to university. Self-awareness of fast eating was significantly associated with higher body mass index in the fifth grade (P < 0.001), and systolic blood pressure and fasting plasma glucose tended to be higher in students who were strongly aware that they would not have breakfast (P = 0.071 and P = 0.053, respectively). Conclusions: The results indicated that the habits of “fast eating” and “not eating breakfast” respectively increase weight and may cause metabolic disorders, regardless of current weight. Thus, it is important for students to be self-aware of unhealthy eating behaviors in daily life. Although it was developed for the medical treatment of obese patients, the questionnaire on eating behaviors may be useful for helping university students learn eating behavior habits and peculiarities as well as health education. J Endocrinol Metab. 2020;10(5):131-139 doi: https://doi.org/10.14740/jem687","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41728813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To keep good glycemic control and suppress the development of diabetic complication, diet therapy is a very crucial treatment for type 2 diabetes. Recently, the effectiveness of carbohydrate-restricted diet, and the diet for sarcopenia and frailty have been suggested, inducing the paradigm shift of diet for type 2 diabetes. There is insufficient evidence regarding the distribution of nutrients in the diet of patients with type 2 diabetes. Here, we reviewed the current state of evidences and guidelines regarding energy allocation of nutrients for patients who have already developed diabetes. At present, any Japanese and international guidelines did not clearly describe an appropriate energy intake proportion of three major nutrients for treatment of type 2 diabetes. The tailor-made medicine should also be applied to the diet for type 2 diabetes. When setting the nutritional balance of diabetic patients, first, we should fully understand each patient’s current situation and make appropriate adjustments, taking into the account of changes in body weight, blood glucose and lipid levels, patient preferences, and feasibility. J Endocrinol Metab. 2020;10(5):113-117 doi: https://doi.org/10.14740/jem693
{"title":"An Appropriate Energy Intake Proportion of Three Major Nutrients for Treatment of Type 2 Diabetes","authors":"H. Yanai, H. Katsuyama","doi":"10.14740/jem693","DOIUrl":"https://doi.org/10.14740/jem693","url":null,"abstract":"To keep good glycemic control and suppress the development of diabetic complication, diet therapy is a very crucial treatment for type 2 diabetes. Recently, the effectiveness of carbohydrate-restricted diet, and the diet for sarcopenia and frailty have been suggested, inducing the paradigm shift of diet for type 2 diabetes. There is insufficient evidence regarding the distribution of nutrients in the diet of patients with type 2 diabetes. Here, we reviewed the current state of evidences and guidelines regarding energy allocation of nutrients for patients who have already developed diabetes. At present, any Japanese and international guidelines did not clearly describe an appropriate energy intake proportion of three major nutrients for treatment of type 2 diabetes. The tailor-made medicine should also be applied to the diet for type 2 diabetes. When setting the nutritional balance of diabetic patients, first, we should fully understand each patient’s current situation and make appropriate adjustments, taking into the account of changes in body weight, blood glucose and lipid levels, patient preferences, and feasibility. J Endocrinol Metab. 2020;10(5):113-117 doi: https://doi.org/10.14740/jem693","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44958831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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