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Chi Y, Zhu L, Wang Y, Peng C, Lin Y, Ji S, Wei J. Long-term Bisphenol S exposure induced gut microbiota dysbiosis, obesity, hepatic lipid accumulation, intestinal lesions and dyslipidemia in mice. Toxicology 2024; 504:153798. [PMID: 38588857 DOI: 10.1016/j.tox.2024.153798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/10/2024]
Abstract
Bisphenol S (BPS) is a commonly detected chemical raw material in water, which poses significant threats to both the ecological environment and human health. Despite being recognized as a typical endocrine disruptor and a substitute for Bisphenol A, the toxicological effects of BPS remain nonnegligible. In order to comprehensively understand the health impacts of BPS, a long-term (154 days) exposure experiment was conducted on mice, during which the physiological indicators of the liver, intestine, and blood were observed. The findings revealed that exposure to BPS resulted in dysbiosis of the gut microbiota, obesity, hepatic lipid accumulation, intestinal lesions, and dyslipidemia. Furthermore, there exists a significant correlation between gut microbiota and indicators of host health. Consequently, the identification of specific gut microbiota can be considered as potential biomarkers for the evaluation of risk associated with BPS. This study will effectively address the deficiency in toxicological data pertaining to BPS. The novel BPS data obtained from this research can serve as a valuable reference for professionals in the field.
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Affiliation(s)
- Yulang Chi
- College of Oceanology and Food Science, Quanzhou Normal University, Quanzhou 362000, China
| | - Lin Zhu
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory & State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Yihui Wang
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory & State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Cai Peng
- Department of Basic Medical Sciences, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Yi Lin
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory & State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Shouping Ji
- College of Oceanology and Food Science, Quanzhou Normal University, Quanzhou 362000, China.
| | - Jie Wei
- Department of Basic Medical Sciences, School of Medicine, Xiamen University, Xiamen 361102, China.
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3
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García-Pérez J, Fernández de Larrea-Baz N, Lope V, Molina AJ, O'Callaghan-Gordo C, Alonso MH, Rodríguez-Suárez MM, Mirón-Pozo B, Alguacil J, Gómez-Acebo I, Ascunce N, Vanaclocha-Espi M, Amiano P, Chirlaque MD, Simó V, Jiménez-Moleón JJ, Tardón A, Moreno V, Castaño-Vinyals G, Martín V, Aragonés N, Pérez-Gómez B, Kogevinas M, Pollán M. Residential proximity to industrial pollution sources and colorectal cancer risk: A multicase-control study (MCC-Spain). ENVIRONMENT INTERNATIONAL 2020; 144:106055. [PMID: 32827807 DOI: 10.1016/j.envint.2020.106055] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/16/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Colorectal cancer is the third most frequent tumor in males and the second in females worldwide. In Spain, it is an important and growing health problem, and epidemiologic research focused on potential risk factors, such as environmental exposures, is necessary. OBJECTIVES To analyze the association between colorectal cancer risk and residential proximity to industries, according to pollution discharge route, industrial groups, categories of carcinogens and other toxic substances, and specific pollutants released, in the context of a population-based multicase-control study of incident cancer carried out in Spain (MCC-Spain). METHODS MCC-Spain included 557 colorectal cancer cases and 2948 controls in 11 provinces, frequency matched by sex, age, and region of residence. Distances were computed from subjects' residences to each of the 134 industries located in the study area. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1 km to 3 km) to industrial facilities, adjusting for matching variables and other confounders. RESULTS Excess risk (OR; 95%CI) of colorectal cancer was detected near industries overall for all distances analyzed, from 1 km (2.03; 1.44-2.87) to 3 km (1.26; 1.00-1.59). In general, industries releasing pollutants to air showed higher excess risks than facilities releasing pollution to water. By industrial sector, excess risk (OR; 95%CI) was found near (≤3 km) production of metals (2.66; 1.77-4.00), surface treatment of metals (1.48; 1.08-2.02), glass and mineral fibers (2.06; 1.39-3.07), organic chemical industry (4.80; 3.20-7.20), inorganic chemical industry (6.74; 4.38-10.36), food/beverage sector (3.34; 2.38-4.68), and surface treatment using organic solvents (6.16; 4.06-9.36). By pollutants, the main excess risks (OR; 95%CI) were found near (≤3 km) industries releasing nonylphenol (9.19; 5.91-14.28), antimony (5.30; 3.45-8.15), naphthalene (3.11; 2.16-4.49), organotin compounds (2.64; 1.76-3.98), manganese (2.53; 1.63-3.93), dichloromethane (2.52; 1.74-3.66), and vanadium (2.49; 1.59-3.91). CONCLUSIONS Our results support the hypothesis that residing in the proximity of industries may be a risk factor for colorectal cancer.
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Affiliation(s)
- Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Nerea Fernández de Larrea-Baz
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Antonio J Molina
- The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institute of Biomedicine (IBIOMED), Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain.
| | - Cristina O'Callaghan-Gordo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla de Poblenou 156, 08018 Barcelona, Spain; Institute of Global Health (ISGlobal), Carrer del Rosselló 132, 08036 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Campus del Mar, Carrer del Dr. Aiguader 80, 08003 Barcelona, Spain.
| | - María Henar Alonso
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Hospital Duran i Reynals, Avinguda de la Gran Via de l'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Avinguda de la Gran Via de l'Hospitalet 199, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Carrer de Casanova 143, 08036 Barcelona, Spain.
| | - Marta María Rodríguez-Suárez
- Hospital Universitario Central de Asturias (HUCA), Av. Roma s/n, 33011 Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Public Health Department, Universidad de Oviedo, 33003 Oviedo, Spain
| | - Benito Mirón-Pozo
- Service of Surgery, Hospital Universitario Clínico San Cecilio, Av. del Conocimiento s/n, 18016 Granada, Spain.
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071 Huelva, Spain.
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Universidad de Cantabria - IDIVAL, Avenida Cardenal Herrera Oria s/n, 39011 Santander, Spain.
| | - Nieves Ascunce
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Navarra Public Health Institute, Calle Leyre, 15, 31003 Pamplona, Navarra; IdiSNA, Navarra Institute for Health Research, Calle Leyre 15, 31003 Pamplona, Spain.
| | - Mercedes Vanaclocha-Espi
- Cancer and Public Health Area, FISABIO - Public Health, Avda. de Catalunya 21, 46020 Valencia, Spain.
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Health Research Institute, Ministry of Health of the Basque Government, Paseo Dr. Beguiristain s/n, 20014 San Sebastian, Spain.
| | - María Dolores Chirlaque
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Campus de Ciencias de la Salud, Carretera Buenavista s/n, 30120 El Palmar, Murcia, Spain.
| | - Vicente Simó
- Department of General Surgery, León University Hospital (CAULE), Altos de Nava s/n, 24071 León, Spain.
| | - José J Jiménez-Moleón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Av. de la Investigación 11, 18016 Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Doctor Azpitarte 4 4ª Planta, Edificio Licinio de la Fuente, 18012 Granada, Spain.
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Instituto Universitario de Oncología (IUOPA), Universidad de Oviedo, Facultad de Medicina, Campus de El Cristo B, 33006 Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. Roma s/n, 33011 Oviedo, Spain.
| | - Víctor Moreno
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Hospital Duran i Reynals, Avinguda de la Gran Via de l'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Avinguda de la Gran Via de l'Hospitalet 199, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Carrer de Casanova 143, 08036 Barcelona, Spain.
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Institute of Global Health (ISGlobal), Carrer del Rosselló 132, 08036 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Campus del Mar, Carrer del Dr. Aiguader 80, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Dr. Aiguader 88, 08003 Barcelona, Spain.
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; The Research Group in Gene - Environment and Health Interactions (GIIGAS)/Institute of Biomedicine (IBIOMED), Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain; Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Campus Universitario de Vegazana, 24071 León, Spain.
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, C/San Martín de Porres, 6, 28035 Madrid, Spain.
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain; Institute of Global Health (ISGlobal), Carrer del Rosselló 132, 08036 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Campus del Mar, Carrer del Dr. Aiguader 80, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Carrer del Dr. Aiguader 88, 08003 Barcelona, Spain.
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Av. de Monforte de Lemos 3-5, 28029 Madrid, Spain.
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Johanson SM, Swann JR, Umu ÖCO, Aleksandersen M, Müller MHB, Berntsen HF, Zimmer KE, Østby GC, Paulsen JE, Ropstad E. Maternal exposure to a human relevant mixture of persistent organic pollutants reduces colorectal carcinogenesis in A/J Min/+ mice. CHEMOSPHERE 2020; 252:126484. [PMID: 32199166 DOI: 10.1016/j.chemosphere.2020.126484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 06/10/2023]
Abstract
An increased risk of developing colorectal cancer has been associated with exposure to persistent organic pollutants (POPs) and alteration in the gut bacterial community. However, there is limited understanding about the impact of maternal exposure to POPs on colorectal cancer and gut microbiota. This study characterized the influence of exposure to a human relevant mixture of POPs during gestation and lactation on colorectal cancer, intestinal metabolite composition and microbiota in the A/J Min/+ mouse model. Surprisingly, the maternal POP exposure decreased colonic tumor burden, as shown by light microscopy and histopathological evaluation, indicating a restriction of colorectal carcinogenesis. 1H nuclear magnetic resonance spectroscopy-based metabolomic analysis identified alterations in the metabolism of amino acids, lipids, glycerophospholipids and energy in intestinal tissue. In addition, 16S rRNA sequencing of gut microbiota indicated that maternal exposure modified fecal bacterial composition. In conclusion, the results showed that early-life exposure to a mixture of POPs reduced colorectal cancer initiation and promotion, possibly through modulation of the microbial and biochemical environment. Further studies should focus on the development of colorectal cancer after combined maternal and dietary exposures to environmentally relevant low-dose POP mixtures.
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Affiliation(s)
- Silje M Johanson
- Department of Production Animal Clinical Sciences, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
| | - Jonathan R Swann
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, SW7 2AZ, United Kingdom.
| | - Özgün C O Umu
- Department of Paraclinical Sciences, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
| | - Mona Aleksandersen
- Department of Preclinical Sciences and Pathology, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
| | - Mette H B Müller
- Department of Paraclinical Sciences, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
| | - Hanne F Berntsen
- Department of Production Animal Clinical Sciences, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway; National Institute of Occupational Health, P.O. Box 5330 Majorstuen, NO-0304, Oslo, Norway.
| | - Karin E Zimmer
- Department of Preclinical Sciences and Pathology, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
| | - Gunn C Østby
- Department of Production Animal Clinical Sciences, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
| | - Jan E Paulsen
- Department of Paraclinical Sciences, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
| | - Erik Ropstad
- Department of Production Animal Clinical Sciences, Norwegian University of Life Sciences, P.O. Box 369 Sentrum, NO-0102, Oslo, Norway.
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Park SY, Choi EM, Suh KS, Kim HS, Chin SO, Rhee SY, Kim DY, Oh S, Chon S. Tetrabromobisphenol A Promotes the Osteoclastogenesis of RAW264.7 Cells Induced by Receptor Activator of NF-kappa B Ligand In Vitro. J Korean Med Sci 2019; 34:e267. [PMID: 31650720 PMCID: PMC6813422 DOI: 10.3346/jkms.2019.34.e267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/05/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Tetrabromobisphenol A (TBBPA), one of the most widely used brominated flame-retardants, is a representative persistent organic pollutants group. Studies on TBBPA toxicity have been conducted using various target cells; however, few studies have investigated TBBPA toxicity in bone cells. Therefore, this study investigated the in vitro effects of TBBPA on osteoclasts, a cell type involved in bone metabolism. METHODS RAW264.7 cells were cultured in medium containing 50 ng/mL receptor activator of nuclear factor kappa B ligand (RANKL) and varying concentrations of TBBPA. To evaluate the effects of TBBPA on the differentiation and function of osteoclasts, osteoclast-specific gene expression, tartrate-resistant acid phosphatase (TRAP) activity, bone resorbing activity, mitochondrial membrane potential (MMP) and mitochondrial superoxide were measured. RESULTS The presence of 20 μ TBBPA significantly increased TRAP activity in RANKL-stimulated RAW264.7 cells, the bone resorbing activity of osteoclasts, and the gene expression of Akt2, nuclear factor of activated T-cells cytoplasmic 1, and chloride channel voltage-sensitive 7. However, TBBPA treatment caused no change in the expression of carbonic anhydrase II, cathepsin K, osteopetrosis-associated transmembrane protein 1, Src, extracellular signal-related kinase, GAB2, c-Fos, or matrix metalloproteinase 9. Furthermore, 20 μ TBBPA caused a significant decrease in MMP and a significant increase in mitochondrial superoxide production. CONCLUSION This study suggests that TBBPA promotes osteoclast differentiation and activity. The mechanism of TBBPA-stimulated osteoclastogenesis might include increased expression of several genes involved in osteoclast differentiation and reactive oxygen species production.
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Affiliation(s)
- So Young Park
- Department of Endocrinology & Metabolism, Kyung Hee University Hospital, Seoul, Korea
| | - Eun Mi Choi
- Department of Endocrinology & Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kwang Sik Suh
- Department of Endocrinology & Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hyun Sook Kim
- Department of Biomedical Laboratory Science, College of Health and Medical Sciences, Cheongju University, Cheongju, Korea
| | - Sang Ouk Chin
- Department of Endocrinology & Metabolism, Kyung Hee University Hospital, Seoul, Korea
- Department of Endocrinology & Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sang Youl Rhee
- Department of Endocrinology & Metabolism, Kyung Hee University Hospital, Seoul, Korea
- Department of Endocrinology & Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Deog Yoon Kim
- Department of Nuclear Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seungjoon Oh
- Department of Endocrinology & Metabolism, Kyung Hee University Hospital, Seoul, Korea
- Department of Endocrinology & Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Suk Chon
- Department of Endocrinology & Metabolism, Kyung Hee University Hospital, Seoul, Korea
- Department of Endocrinology & Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
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