Hypophysitis from immune checkpoint inhibitors: challenges in diagnosis and management
Purpose of review This review will summarize the most recent and pertinent evidence regarding immune checkpoint inhibitor (ICI)-induced hypophysitis to describe diagnostic and management algorithm with the help of a case report. Recent findings Hypophysitis is the most common endocrine adverse event from CTLA-4 inhibitors and much less with PD-1/PD-L1 inhibitors. Its pathophysiology appears to be lymphocytic, predominantly affecting the anterior pituitary. The utility of high-dose glucocorticoids for treatment has been questioned, as they do not influence recovery of hypopituitarism and may reduce survival. A su...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: NEUROENDOCRINOLOGY: Edited by Emory Hsu Source Type: research

Acromegaly: achieving timely diagnosis and improving outcomes by personalized care
Purpose of review Discuss recent literature regarding clinical manifestations and comorbidities in acromegaly, with focus on early diagnosis and customized care. Recent findings The mean interval between onset of clinical manifestations and diagnosis is currently 3–5 years. Women, especially younger than 50 years of age, experience longer delays, have lower insulin-like growth factor 1 (IGF-1) levels and larger tumors than men. Development of comorbidities usually precedes the diagnosis and is influenced by age, sex, and biochemical disease activity. Comorbidities other than irreversible osteoarticular s...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: NEUROENDOCRINOLOGY: Edited by Emory Hsu Source Type: research

Current state of antigen-specific immunotherapy for type 1 diabetes
Purpose of review Update on antigen-specific immunotherapy (ASIT) in type 1 diabetes (T1D) with focus on deoxyribonucleic acid (DNA)-induced immunization and the current obstacles to further research and clinical realization. Recent findings In T1D, immune system imbalances together with malfunctioning islet-specific processes cause autoreactive immune cells to destroy beta cells in the islets. ASIT may restore self-tolerance; however, the approach has yet to fully meet its promise and may require co-administration of antigen (preproinsulin) and suitable immune response modifiers. Summary A self-tolerant ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter Gottlieb Source Type: research

Novel delivery mechanisms for antigen-specific immunotherapy
Purpose of review Current therapies for autoimmune disorders often employ broad suppression of the immune system. Antigen-specific immunotherapy (ASI) seeks to overcome the side-effects of immunosuppressive therapy by specifically targeting only disease-related autoreactive T and B cells. Although it has been in development for several decades, ASI still is not in use clinically to treat autoimmunity. Novel ways to deliver antigen may be effective in inducing ASI. Here we review recent innovations in antigen delivery Recent findings New ways to deliver antigen include particle and nonparticle approaches. One mai...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter Gottlieb Source Type: research

Breaking and restoring immune tolerance to pancreatic beta-cells in type 1 diabetes
Purpose of review Type 1 diabetes (T1D) results from the loss of immune tolerance to pancreatic beta-cells leading to their destruction. Immune intervention therapies tested in T1D so far delayed progression but failed to restore tolerance, which partly explains their lack of durable clinical efficacy. Recent findings The role of beta-cells and islets themselves in dialogue with their micro- and macro-environment including the immune system and the intestinal microbiome is increasingly evident. Indeed, islets can both maintain and break immune tolerance. Some recent immune therapies in cancer that block immune r...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter Gottlieb Source Type: research

Insulin immunotherapy for pretype 1 diabetes
Purpose of review Loss of tolerance to insulin likely contributes to the immunopathogenesis of type 1 diabetes (T1D). Several large clinical trials and smaller mechanistic studies have failed to demonstrate the efficacy of insulin antigen therapy. The growing awareness of the heterogeneity of T1D likely affects the response to various immune therapies including insulin. Identification of biomarkers of clinical response will provide further insight into mechanisms leading to the disease and classify responders in the quest for personalized therapy. Recent findings Several biomarkers have identified subpopulations...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter Gottlieb Source Type: research

Bone health in diabetes: Indian perspective
Purpose of review Despite estimated 77 million people having diabetes, bone health in Asian Indians with diabetes is largely unknown. This review summarizes the published literature on fracture risk and factors affecting it in Asian Indians with diabetes. Recent findings Data on fracture prevalence in diabetes is limited; one study showed that diabetes was associated with a significantly higher number of fractures compared with subjects without diabetes (4% vs. 2.4%, P  (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Treatment of bone fragility in patients with diabetes: antiresorptive versus anabolic?
Purpose of review The pathogenesis of bone fragility in diabetes has not been fully characterized. The antifracture efficacy of available therapies remains unproven in patients with diabetes. We aim to collate current evidence of the treatment of diabetic bone fragility, and to provide a rationale for considering optimal therapeutic option in patients with diabetes. Recent findings The antifracture efficacy of antiresorptive and anabolic therapies is well established in patients without diabetes. Studies in patients with osteoporosis have shown that anabolic therapies lead to faster and larger benefits to bone m...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Future studies using histomorphometry in type 1 diabetes mellitus
This article reviews the current state of research in type 1 diabetes and bone, focusing on human bone turnover markers and histomorphometry. Recent findings Bone turnover markers have been used for decades to document static bone turnover status in a variety of diseases but especially in diabetes. Two new studies focus on dynamic testing conditions to examine the acute effects of insulin and exercise on bone turnover. Publications of human bone histomorphometry in type 1 diabetes are few but there are several new studies currently underway. Summary Here, we review the most recent literature on human bone tur...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Advanced glycation endproducts and bone quality: practical implications for people with type 2 diabetes
Purpose of review Individuals with type 2 diabetes (T2D) are at increased risk of fracture, often despite normal bone density. This observation suggests deficits in bone quality in the setting of abnormal glucose homeostasis. The goal of this article is to review recent developments in our understanding of how advanced glycation end products (AGEs) are incorporated into the skeleton with resultant deleterious effects on bone health and structural integrity in patients with T2D. Recent findings The adverse effects of skeletal AGE accumulation on bone remodeling and the ability of the bone to deform and absorb ene...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Are diabetes microvascular complications risk factors for fragility fracture?
We describe relationships between microvascular complications and bone fragility fracture in the context of diabetes. We highlight gaps in knowledge and suggest areas of further study. Recent findings Evidence in type 1 diabetes (T1D) demonstrates that low bone mineral density (BMD) is associated with microvascular complications and linked to increased fracture risk. Of note, the low BMD does not solely explain bone fragility. Microvascular disease also has been linked to compromised bone microarchitecture and poorer bone quality. Moreover, microvascular complications may indirectly increase the rate of fragility fr...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Sleep disruptions and bone health: what do we know so far?
Purpose of review This review briefly summarizes the growing body of literature addressing the skeletal consequences of sleep and circadian disruption. Recent findings The most recent data in the field suggest that the diurnal variation in bone turnover markers are because of endogenous circadian rhythmicity linked to clock genes in all bone cells; in a small human intervention study, cumulative sleep restriction with concurrent circadian disruption negatively alter bone turnover markers in a way that could explain the lower BMD and increased fracture risk identified in some prior night shift work studies; abnor...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Bone accrual in children and adolescents with type 1 diabetes: current knowledge and future directions
Purpose of review Skeletal fragility is now recognized as a significant complication of type 1 diabetes (T1D). Many patients with T1D develop the disease in childhood and prior to the attainment of peak bone mass and strength. This manuscript will review recent studies investigating the effects of T1D on skeletal development. Recent findings Mild-to-moderate deficits in bone density, structure, and mineral accrual were reported early in the course of T1D in some but not all studies. Childhood-onset disease was associated with a more severe skeletal phenotype in some adult studies. Lower than expected bone mass f...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Editorial: Bone health in type 1 and type 2 diabetes: current knowledge and future direction
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: PARATHYROIDS, BONE AND MINERAL METABOLISM: Edited by Viral N. Shah Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 15, 2021 Category: Endocrinology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Thromboembolic disease in hypercortisolism
Purpose of review Endogenous Cushing's syndrome (CS) is associated with increased patient morbidity (hypertension, diabetes mellitus, dyslipidemia, visceral obesity, osteoporosis, cognitive alterations, and impaired quality of life). Both arterial and venous thromboembolic events (TE) due to alterations in the hemostatic system and prothrombotic state are widely reported in patients with CS, more so postoperatively. Increased mortality, if not appropriately treated, is largely due to cardiovascular events and infections. Recent findings Patients with CS have markedly increased risk of thromboembolic episodes com...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Psychological complications of Cushing's syndrome
Purpose of review The aim of this article is to review and discuss recent evidence of psychological complications in Cushing's syndrome. Recent findings Recent research has described the presence of depression, anxiety, posttraumatic stress disorder, mania, bipolar disorder and psychotic symptoms in patients with Cushing's syndrome. Furthermore, the perspective of patients’ partners has also been emphasized. Summary Recent literature highlights the importance of screening for psychological alterations in Cushing's syndrome, as these alterations can be present in many patients, having a high impact i...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Clinical outcomes in 21-hydroxylase deficiency
Purpose of review The introduction of synthetic glucocorticoids 70 years ago made survival possible in classic 21-hydroxylase deficiency (21OHD). The currently used glucocorticoid therapy may lead to unphysiological dosing with negative consequencies on health in addition to the problems that may arise due to androgen over-exposure. Recent findings Fertility in females with 21OHD seemed to be impaired, especially in the salt-wasting (SW) phenotype but when pregnancies did occur there was a higher risk for gestational diabetes and cesearean section. Increased fat mass, body mass index, insulin resistance and fr...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Chronic kidney disease in adrenal disorders
Purpose of review This review will focus on hypertension due to underlying adrenal disorders in chronic kidney disease (CKD). Diagnosis of adrenal hypertension and particularly primary aldosteronism (PA) in CKD is frequently not pursued. We outline limitations that advanced kidney disease poses on the diagnostic work up of these disorders and provide a framework for approaching CKD patients suspected of having an adrenal disorder. Recognition of these disorders is important as they are often underdiagnosed which leads to poorer outcomes. Recent findings Adrenal disease associated with hypertension in CKD is most...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Current and future treatment options for adrenal insufficiency
Purpose of review Patients with adrenal insufficiency (AI) irrespective of being on glucocorticoid replacement therapy still suffer from increased morbidity and mortality. A major contributing factor is an inability of conventional glucocorticoid treatment to mirror the physiological cortisol rhythm. Novel strategies to replicate the cortisol rhythm using hydrocortisone infusion pumps and oral modified release hydrocortisone have now been developed and confirmed to offer benefits to patients. Recent findings In the DREAM study, when compared to multiple daily dosing of glucocorticoids Plenadren reduced weight, w...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Thermal ablation in adrenal disorders: a discussion of the technology, the clinical evidence and the future
Purpose of review To summarise the emerging role of thermal ablation as a therapeutic modality in the management of functioning adrenal tumours and metastases to the adrenal gland. Recent findings Observational evidence has demonstrated the benefit of thermal ablation in (i) resolving adrenal endocrinopathy arising from benign adenomas, (ii) treating solitary metastases to the adrenal and (iii) controlling metastatic adrenocortical carcinoma and phaeochromocytoma/paraganglioma. Summary Microwave thermal ablation offers a promising, minimally invasive therapeutic modality for the management of functioning ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Genetics of pheochromocytoma and paraganglioma
Purpose of review This review summarizes our current understanding of germline and somatic genetics and genomics of pheochromocytomas and paragangliomas (PCC/PGL), describes existing knowledge gaps, and discusses future research directions. Recent findings Germline pathogenic variants (PVs) are found in up to 40% of those with PCC/PGL. Tumors with germline PVs are broadly categorized as Cluster 1 (pseudohypoxia), including those with SDH, VHL, FH, and EPAS1 PVs, or Cluster 2 (kinase signaling) including those with NF1, RET, TMEM127, and MAX PVs. Somatic driver mutations exist in some of the same genes (RET, VHL,...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas
Purpose of review The incidence of adrenal tumors has increased over the past 20 years, most of which are incidentally discovered nonfunctioning adenomas (NFA) and tumors with mild autonomous cortisol secretion (MACS). This review aimed to summarize recent progress in understanding cardiometabolic risk in patients with NFA and MACS and to provide updates on the effect of treatment on improving outcomes in this population. Recent findings NFA and MACS are associated with adverse cardiovascular risk factors and metabolic derangements, which are likely mediated by excessive glucocorticoid secretion. Recent studie...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Approach to large adrenal tumors
Purpose of review To summarize the data concerning approach to large adrenal tumors (LAT's), since recent guidelines published in 2016 recommend individual approach rather than clear size cut-off of a tumor that should be removed. Recent findings Although the risk of malignancy clearly correlates with the size of a lesion, tumor size of more than 4 cm in diameter represents only 31–61% specificity for the diagnosis of malignant tumor. Therefore, the risk of malignancy and decision about surgery should not be based only on the size of a tumor but assessed in terms of imaging studies, growth pattern during...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Approach to patients with European Network for the Study of Adrenal Tumor stages I and II adrenocortical carcinomas
This article elaborates on the current understanding of the clinical approach to this group of patients. Recent findings Concerning the treatment, complete surgical resection of the tumor provides the only chance for cure. However, even after tumor removal, the risk of recurrence remains high and the main predictors of recurrence include tumor stage, grade (measured by Ki-67 proliferative index), and the tumor resection status. Adjuvant mitotane and/or adjuvant radiotherapy should be considered in patients with high risk of recurrence taking into account potential harmful effects of such treatment. Accordingly, care...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Editorial
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Established and emerging roles peptide YY (PYY) and exploitation in obesity–diabetes
Purpose of review The antiobesity effects of activation of hypothalamic neuropeptide Y2 receptors (NPYR2) by the gut-derived hormone, peptide YY (PYY), are established. However, more recent insight into the biology of PYY has demonstrated remarkable benefits of sustained activation of pancreatic beta-cell NPYR1, that promises to open a new therapeutic avenue in diabetes. Recent findings The therapeutic applicability of NPYR2 agonists for obesity has been considered for many years. An alternative pathway for the clinical realisation of PYY-based drugs could be related to the development of NPYR1 agonists for trea...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Gut peptides and the microbiome: focus on ghrelin
Purpose of review In this review, we present recent insights into the role of the gut microbiota on gastrointestinal (GI) peptide secretion and signalling, with a focus on the orexigenic hormone, ghrelin. Recent findings Evidence is accumulating suggesting that secretion of GI peptides is modulated by commensal bacteria present in our GI tract. Recent data shows that the gut microbiome impacts on ghrelinergic signalling through its metabolites, at the level of the ghrelin receptor (growth hormone secretagogue receptor) and highlights concomitant changes in circulating ghrelin levels with specific gut microbiota ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Ghrelin-cell physiology and role in the gastrointestinal tract
Purpose of review Ghrelin was discovered in 1999; extensive research and clinical studies on ghrelin have been published in the last 20 years. Physiological research on ghrelin ranges from its appetite-stimulating effects to its association with energy homeostasis. The physiological effects of ghrelin in the gastrointestinal tract and its relevance in the pathological conditions of the gastrointestinal tract have gradually become clearer. The purpose of the review is to provide current information on ghrelin cell biology and physiology, particularly in the gastrointestinal tract. Recent findings Ghrelin-producin...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Recent advances in the biology of bombesin-like peptides and their receptors
Purpose of review The current review aims to update the important findings about molecular and cellular biology of mammalian bombesin-like peptides (BLPs) and their receptors. Recent findings Recent identification of synaptic communication between gastrin-releasing peptide (GRP) neurons and GRP receptor (GRPR) neurons in spinal itch relay provides us novel insights into physiology of itch sensation. Neuromedin B (NMB) neurons were found to form connections with subcortical areas associated with arousal, hippocampal theta oscillation, and premotor processing and project to multiple downstream stations to regulate...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Chemosensing in enteroendocrine cells: mechanisms and therapeutic opportunities
Purpose of review Enteroendocrine cells (EECs) are scattered chemosensory cells in the intestinal epithelium that release hormones with a wide range of actions on intestinal function, food intake and glucose homeostasis. The mechanisms by which gut hormones are secreted postprandially, or altered by antidiabetic agents and surgical interventions are of considerable interest for future therapeutic development. Recent findings EECs are electrically excitable and express a repertoire of G-protein coupled receptors that sense nutrient and nonnutrient stimuli, coupled to intracellular Ca2+ and cyclic adenosine monoph...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Targeted pharmacotherapy of irritable bowel syndrome
Purpose of review Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal (GI) disorder with negative impact on quality of life and it represents a substantial economic burden on healthcare cost. The medical management of IBS is symptom directed. This review provides an update related to clinical trial data for novel treatment modalities in IBS targeting the gut epithelium secretagogue receptors and channels. Recent findings The new Rome IV criteria define functional gastrointestinal disorders (FGID) as disorders of the gut–brain interaction. Pharmacological treatment modalities fo...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Pituitary adenylate cyclase-activating polypeptide/vasoactive intestinal peptide (Part 2): biology and clinical importance in central nervous system and inflammatory disorders
Purpose of review To discuss recent advances of vasoactive intestinal peptide/pituitary adenylate cyclase-activating polypeptide (VIP/PACAP) receptors in the selected central nervous system (CNS) and inflammatory disorders. Recent findings Recent studies provide evidence that PACAP plays an important role in a number of CNS disorders, particularly the pathogenesis of headaches (migraine, etc.) as well as posttraumatic stress disorder and drug/alcohol/smoking addiction. VIP has important therapeutic effects in a number of autoimmune/inflammatory disorder such as rheumatoid arthritis. In some cases, these insights...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Pituitary adenylate cyclase-activating polypeptide/vasoactive intestinal peptide [Part 1]: biology, pharmacology, and new insights into their cellular basis of action/signaling which are providing new therapeutic targets
Purpose of review To discuss recent advances of vasoactive intestinal peptide (VIP)/pituitary adenylate cyclase-activating polypeptide (PACAP) receptors in pharmacology, cell biology, and intracellular signaling in cancer. Recent findings Recent studies provide new insights into the pharmacology, cell biology of the VIP/PACAP system and show they play important roles in a number of human cancers, as well as in tumor growth/differentiation and are providing an increased understanding of their signaling cascade that is suggesting new treatment targets/approaches. Summary Recent insights from studies of VIP/...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Editorial: Gastrointestinal regulatory peptides
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Novel therapies for familial hypercholesterolemia
Purpose of review Familial hypercholesterolemia is a genetic disorder of defective clearance and subsequent increase in serum LDL cholesterol (LDL-C) with a resultant increased risk of premature atherosclerotic cardiovascular disease. Despite treatment with traditional lipid-lowering therapies (LLT), most patients with familial hypercholesterolemia are unable to achieve target LDL-C. We review current and future novel therapeutic options available for familial hypercholesterolemia. Recent findings The use of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors are effective in lowering LDL-C in patie...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Lipoprotein (a) and diabetes mellitus: causes and consequences
Purpose of review This review provides an update on the role of lipoprotein (a) [Lp(a)] in diabetes, including its impact as a risk factor as well as its contribution to the development of cardiovascular disease. Recent findings Although a specific role for Lp(a) has not yet been conclusively established, it appears to have an inverse association with risk of diabetes. Several population-based studies have demonstrated associations between low levels of Lp(a) and increased risk of type 2 diabetes, but Mendelian randomization studies do not consistently support causality. Conversely, in patients with type 2 diabe...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Novel behavioural approaches and implementation science for mitigating genetic risk of cardiovascular disease due to elevated lipoprotein(a)
Purpose of review Elevated lipoprotein(a) [Lp(a)] is a genetic trait that indicates higher risk of atherosclerotic cardiovascular disease (ASCVD). We review novel strategies to mitigate behavioural risk-factors in this genetic condition. Recent findings Pharmacological and biological interventions are available for lowering Lp(a). However, the acceptability and feasibility of these approaches are questionable due to cost and lack of clinical evidence for their efficacy. A number of low-cost, minimal patient contact interventions are available for modifying behavioural risk-factors that are associated with increa...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Expert position statements: comparison of recommendations for the care of adults and youth with elevated lipoprotein(a)
Purpose of review Summarize recent recommendations on clinical management of adults and youth with elevated lipoprotein(a) [Lp(a)] who are at-risk of or affected by cardiovascular disease (CVD). Recent findings There is ample evidence to support elevated Lp(a) levels, present in approximately 20% of the general population, as a causal, independent risk factor for CVD and its role as a significant risk enhancer. Several guidelines and position statements have been published to assist in the identification, treatment and follow-up of adults with elevated levels of Lp(a). There is growing interest in Lp(a) screenin...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Dyslipidemia in childhood and adolescence: from screening to management
Purpose of review To summarize types of dyslipidemia frequently encountered during childhood and adolescence, with a focus on screening, diagnosis, and management. Recent findings It is important that screening for atherosclerotic cardiovascular disease (ASCVD) begin in childhood. Genetic testing allows for increased awareness of dyslipidemia and more targeted intervention. Pharmacologic treatment of pediatric dyslipidemias has a good safety profile and can reduce adult ASCVD risk. Summary Much of what is known about pediatric dyslipidemia has been extrapolated from adult data, but recently, there have be...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Advances in the management of statin myopathy
Purpose of review Statins are highly effective therapies for reducing low-density lipoprotein cholesterol and preventing cardiovascular events. However, many patients taking statins experience statin-associated muscle symptoms. In the current manuscript, we review algorithms to define statin intolerance and approaches to optimize cardiovascular risk reduction and reduce the nocebo effect among individuals reporting statin-associated muscle pain. Recent findings Patients with statin intolerance have a higher cardiovascular event risk. These data underscore the need to apply clinical strategies that improve treatm...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Dietary management of cardiovascular risk including type 2 diabetes
Purpose of review Recent changes or confirmations linking patterns of eating and specific dietary interventions in the management of cardiovascular risk factors including associations with prevalent and incident type 2 diabetes. Recent findings Recently published guidance for dietary management of cardiovascular risk and type 2 diabetes have mostly common features. Major findings include a trend to replace strict quantitative advice on nutrients with qualitative advice on food consumption with exceptions for diabetes, global advice to increase intake of plant foods, confirmation to substitute mono and polyunsatu...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Use of cardiovascular imaging in risk restratification of the diabetic patient
Purpose of review Diabetes mellitus is no longer considered a cardiovascular disease (CVD) risk equivalent, but the optimal methods of risk stratification are a matter of debate. The coronary calcium score (CCS) is a measure of the burden of atherosclerosis and is widely used for CVD risk stratification in the general population. We review recently published data to describe the role of the CCS in people with diabetes mellitus. Recent findings People with diabetes mellitus have 10-year event rates for CVD and CVD mortality that are considered high, at a much lower level of CCS than the general population. Differ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Transatlantic guidelines on dyslipidemia and cardiovascular risk: key differences across the pond
Purpose of review The purpose of this review is to compare and contrast the key messages from the 2018 American Heart Association (AHA)/American College of Cardiology (ACC) Multisociety Guideline on the Management of Blood Cholesterol and the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) Guidelines for the Management of Dyslipidemias. We also review some of the evidence that served as the basis for these guidelines and share our opinion regarding these guidelines. Recent findings Patients with atherosclerotic cardiovascular disease (ASCVD), severe hypercholesterolemia, familial...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Best practice for treating dyslipidaemia in patients with diabetes based on current international guidelines
Purpose of review Dyslipidaemia is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD) in type 2 diabetes. We provide an in-context overview of recent trials of lipid-lowering pharmacotherapies and of recommendations from international guidelines for managing dyslipidaemia in patients with diabetes. Recent findings Clinical trials have demonstrated that patients with diabetes derive greater benefits from ezetimibe and proprotein convertase subtilisin–kexin type 9 inhibitors owing to the higher absolute ASCVD risk compared with patients without diabetes. Pure eicosapentaenoic a...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Assessing the dyslipidemias: to fast or not to fast?
Purpose of review Nonfasting lipid testing has been introduced into several guidelines over the past decade or so however, the uptake into clinical practice has not been universal. This review highlights some of the prevalent reasons for provider reluctance to use nonfasting testing and the evidence to support nonfasting testing for routine screening in most patients. Recent findings Several studies have found nonfasting lipids to be as, or more, strongly associated with cardiovascular disease (CVD) risk prediction. In particular, nonfasting tests improve system efficiency, are safe for patients with diabetes, t...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Apolipoprotein B: the Rosetta Stone of lipidology
Purpose of review This review summarizes the evidence that apolipoprotein B (apoB) integrates the conventional lipid markers – total cholesterol, triglycerides, LDL-cholesterol, and non-HDL-cholesterol – into a single index that accurately and simply quantitates the atherogenic risk due to the apoB lipoprotein particles. Recent findings Marked hypertriglyceridemia remains the essential signal for hyperchylomicronemia and potential pancreatitis. However, with the exception of Lp(a) and the abnormal cholesterol-enriched remnant particles that are the hallmark of type III hyperlipoproteinemia, recent ev...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease risk: current status and treatments
Purpose of review The role of triglyceride-rich lipoproteins (TRLs) in the development of atherosclerotic cardiovascular disease (ASCVD) is at the forefront of current research and treatment development programs. Despite extreme lowering of LDL-cholesterol there remains a high risk of cardiovascular disease and mortality. Recent large epidemiological, genomic wide association studies and Mendelian randomization studies have identified novel mechanisms and targets regulating TRL. This review will focus on recent and ongoing clinical trials that aim to reduce cardiovascular risk by decreasing plasma levels of TRL. Rec...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research

Editorial: Dyslipidaemia and cardiometabolic health: springboard for an emerging medical specialty?
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: LIPIDS: Edited by Gerald F. Watts Source Type: research