A Case of Hypocalcemia with Severe Vitamin D Deficiency following Treatment for Graves’ Disease with Methimazole

We herein report the case of a 41-year-old Japanese female office worker who developed symptomatic hypocalcemia with severe vitamin D deficiency following treatment for Graves' disease with methimazole. The patient's hypocalcemia was mainly caused by vitamin D deficiency due to unbalanced diets and inadequate exposure to sunlight in addition to the resolution of hyperthyroidism. Vitamin D deficiency is increasing worldwide, and it has been more recently shown to relate to the pathogenesis of Graves' disease. However, vitamin D deficiency as a cause of hypocalcemia has received little attention. Taken together, this case suggests that we should take more care in calcium kinetics and vitamin D status during treatment for Graves' disease with antithyroid drugs

Diabetes mellitus itself increases cardio- cerebrovascular risk and renal complications in primary aldosteronism

This is a pre-copyedited, author-produced version of an article accepted for publication in The Journal of Clinical Endocrinology & Metabolism following peer review. The version of record Aya Saiki, Michio Otsuki, Daisuke Tamada, Tetsuhiro Kitamura, Iichiro Shimomura, Isao Kurihara, Takamasa Ichijo, Yoshiyu Takeda, Takuyuki Katabami, Mika Tsuiki, Norio Wada, Toshihiko Yanase, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Takanobu Yoshimoto, Ryuji Okamoto, Katsutoshi Takahashi, Hiroki Kobayashi, Kouichi Tamura, Kohei Kamemura, Koichi Yamamoto, Shoichiro Izawa, Miki Kakutani, Masanobu Yamada, Akiyo Tanabe, Mitsuhide Naruse, Diabetes Mellitus Itself Increases Cardio-Cerebrovascular Risk and Renal Complications in Primary Aldosteronism, The Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 7, July 2020, Pages e2531–e2537 is available online at: https://doi.org/10.1210/clinem/dgaa177

Vascular complications and changes in body mass index in Japanese type 2 diabetic patients with abdominal obesity

Abstract Background Although many Asian type 2 diabetic patients have been considered to be not obese and have low capacity of insulin secretion, the proportion of obese patients with visceral fat accumulation has increased in recent years. We found previously considerable number of Japanese non-obese subjects (body mass index (BMI) &lt; 25 kg/m2) with visceral fat accumulation and multiple cardiovascular risk factors. The aim of the study was to investigate the difference in clinical features of type 2 diabetic patients with and without visceral fat accumulation, focusing on vascular complications and changes in BMI. Methods We enrolled 88 Japanese hospitalized type 2 diabetic patients. Abdominal obesity represented waist circumference (WC) of ≥85 cm for males and ≥90 cm for females (corresponding to visceral fat area of 100 cm2). Subjects were divided into two groups; with or without abdominal obesity. Results Hypertension, dyslipidemia and cardiovascular diseases were significantly more in the patients with abdominal obesity. The prevalence of cardiovascular disease in the non-obese patients (BMI &lt; 25 kg/m2) with abdominal obesity were similar in obese patients (BMI ≥25 kg/m2). The mean BMI of the patients with abdominal obesity was &lt; 25 kg/m2 at 20 years of age, but reached maximum to more than 30 kg/m2 in the course. Furthermore, substantial portion of the type 2 diabetic patients (52% in males and 43% in females) were not obese at 20 year-old (BMI &lt; 25 kg/m2), but developed abdominal obesity by the time of admission. Conclusion These results emphasize the need to control multiple risk factors and prevent atherosclerotic disease in patients with abdominal obesity. The significant weight gain after 20 years of age in patients with abdominal obesity stresses the importance of lifestyle modification in younger generation, to prevent potential development of type 2 diabetes and future atherosclerotic cardiovascular disease. </jats:sec

SAT-545 Diabetes Mellitus Is the Risk Factor of Cardiovascular and Cerebrovascular Events in Primary Aldosteronism

Abstract The prevalence of diabetes mellitus (DM) in primary aldosteronism (PA) patients is higher than essential hypertension patients and general population. Though both DM and PA play an important role in the progression of cardiovascular and cerebrovascular (CCV) diseases, the relationship between DM and these diseases in PA patients have not been evaluated.The aim of this study was to investigate whether DM was involved in the risk of CCV events and the progression of renal disorder in PA patients. This study was conducted as a part of the Japan Primary Aldosteronism Study/ Japan Rare Intractable Adrenal Diseases Study (JPAS/JRAS) study and retrospective cross-sectional analysis. The nationwide PA registry in Japan was established at 29 centers, including 15 university hospitals and 14 city hospitals. Patients, who were diagnosed PA between January 2006 and October 2016 and had available data of CCV events and DM, were enrolled (n=2,524). Logistic and liner-regression analysis for CCV events and renal parameters were performed. DM significantly increased the odds ratio of CCV events (OR 1.59, 95% CI: 1.05-2.41). DM also significantly increased the odds ratio of proteinuria (OR 2.25, 95% CI: 1.59-3.16) and had significant positive correlation with declines in eGFR (β=0.05, p=0.02). In conclusion, DM is an independent risk factor for CCV events and proteinuria in PA patients. We should pay attention to whether DM coexists with PA and treat both DM and PA to prevent the exacerbation of CCV diseases and kidney disease. (Supported by AMED grants No. JP17ek0109112/ JP19ek0109352; National Center for Global Health and Medicine, Japan (27-1402/ 30-1008)).</jats:p