Endocrinology and Metabolism Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Lipid Disorders and Metabolic-Associated Fatty Liver Disease
Dyslipidemia has been linked metabolic-associated fatty liver disease (MAFLD). Several genes and transcription factors involved in lipid metabolism can increase susceptibility to MAFLD. Multiple parallel ‘hits’ have been proposed for developing hepatic steatosis, NASH, and MAFLD, including insulin resistance and subsequent free fatty acid excess, de novo lipogenesis, and excessive hepatic triglyceride and cholesterol deposition in the liver. This lead to defective beta-oxidation in the mitochond ria and VLDL export and increased inflammation. Given the significant cardiovascular risk, dyslipidemia associated with MAFLD...
Source: Endocrinology and Metabolism Clinics of North America - February 26, 2023 Category: Endocrinology Authors: Shima Dowla Anwar, Christy Foster, Ambika Ashraf Source Type: research

A Bidirectional Association Between Obstructive Sleep Apnea and Metabolic-Associated Fatty Liver Disease
Obesity is considered a twentieth-century epidemic and is a growing concern among health professionals. Obesity and its complications contribute to multiple chronic illnesses, such as type 2 diabetes (T2D), metabolic syndrome, obstructive sleep apnea (OSA), malignancy, and cardiovascular and liver diseases. In the last two  decades, a bidirectional association between OSA and metabolic-associated fatty liver disease (MAFLD), independent of obesity, has been established. Both conditions have similar risk factors and metabolic comorbidities that may imply a common disease pathway. This review compiles the evidence and delin...
Source: Endocrinology and Metabolism Clinics of North America - February 26, 2023 Category: Endocrinology Authors: Anish Preshy, James Brown Source Type: research

Newer Glucose-Lowering Therapies in Older Adults with Type 2 Diabetes
Diabetes is prevalent in older adults and older adults with diabetes are more likely to have multiple comorbidities. It is, therefore, important to personalize diabetes management in this group. Newer glucose-lowering drugs, including dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter 2 inhibitors, and glucagon-like peptide-1 receptor agonists can be safely used in older patients and are preferred choices in many cases due to their safety, efficacy, and low risk of hypoglycemia. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 20, 2023 Category: Endocrinology Authors: Anika Bilal, Richard E. Pratley Source Type: research

Geriatric Syndromes in Older Adults with Diabetes
Over one-quarter of adults ≥65 years old have diabetes in the United States. Guidelines recommend individualization of glycemic targets in older adults with diabetes as well as implementing treatment strategies that minimize risk for hypoglycemia. Patient-centered management decisions should be informed by comorbidities, t he individual’s capacity for self-care, and the presence of key geriatric syndromes that may impact self-management and patient safety. Key geriatric syndromes include cognitive impairment, depression, functional impairments (eg, vision, hearing, and mobility challenges), falls and fractures, poly p...
Source: Endocrinology and Metabolism Clinics of North America - February 19, 2023 Category: Endocrinology Authors: Joshua J. Neumiller, Medha N. Munshi Source Type: research

Sex Hormones and Cardiovascular Disease in Relation to Menopause
Natural menopause is defined as the cessation of menstruation among women who have not undergone hysterectomy or bilateral oophorectomy. The implications of menopause management are particularly important with the aging of the population and increasing awareness of the importance of midlife risk upon longevity. Our understanding of the relationships between reproductive milestones and cardiovascular disease continues to evolve particularly regarding shared determinants of health. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 19, 2023 Category: Endocrinology Authors: Catherine Kim, Melissa Wellons Source Type: research

Thyroid and Aging
Older adults are more vulnerable to the negative effects of excess thyroid hormone and may even be protected by lower levels of thyroid hormone. The diagnosis and management of thyroid disease in older adults needs to account for aging-related changes in function and resilliance. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 19, 2023 Category: Endocrinology Authors: Jennifer S.R. Mammen Source Type: research

Osteoporosis
This article provides a review of the incidence, etiology, and approach to screening and management of osteoporosis in the aging population. A thorough screening of lifestyle, environmental, and clinical conditions will be reviewed which identifies appropriate candidates for screening and treatment. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 19, 2023 Category: Endocrinology Authors: Sonali Khandelwal, Nancy E. Lane Source Type: research

Age-Associated Abnormalities of Water Homeostasis
Deficits in renal function, thirst, and responses to osmotic and volume stimulation have been repeatedly demonstrated in older populations. The lessons learned over the past six  decades serve to emphasize the fragile nature of water balance characteristic of aging. Older individuals are at increased risk for disturbances of water homeostasis due to both intrinsic disease and iatrogenic causes. These disturbances have real-life clinical implications in terms of neurocognit ive effects, falls, hospital readmission and need for long-term care, incidence of bone fracture, osteoporosis, and mortality. (Source: Endocrinology a...
Source: Endocrinology and Metabolism Clinics of North America - February 19, 2023 Category: Endocrinology Authors: Laura E. Cowen, Steven P. Hodak, Joseph G. Verbalis Source Type: research

Obesity and Aging
The obesity epidemic in aging populations poses significant public health concerns for greater morbidity and mortality risk. Age-related increased adiposity is multifactorial and often associated with reduced lean body mass. The criteria used to define obesity by body mass index in younger adults may not appropriately reflect age-related body composition changes. No consensus has been reached on the definition of sarcopenic obesity in older adults. Lifestyle interventions are generally recommended as initial therapy; however, these approaches have limitations in older adults. Similar benefits in older compared with younger...
Source: Endocrinology and Metabolism Clinics of North America - February 16, 2023 Category: Endocrinology Authors: Noemi Malandrino, Salman Z. Bhat, Maha Alfaraidhy, Rajvarun S. Grewal, Rita R. Kalyani Source Type: research

Endocrinology of Taste with Aging
Taste is one of our five primary senses, and taste impairment has been shown to increase with aging. The ability to taste allows us to enjoy the food we eat and to avoid foods that are potentially spoiled or poisonous. Recent advances in our understanding of the molecular mechanisms of taste receptor cells located within taste buds help us decipher how taste works. The discoveries of “classic” endocrine hormones in taste receptor cells point toward taste buds being actual endocrine organs. A better understanding of how taste works may help in reversing taste impairment associated with aging. (Source: Endocrinology and ...
Source: Endocrinology and Metabolism Clinics of North America - February 16, 2023 Category: Endocrinology Authors: Chee W. Chia, Shayna M. Yeager, Josephine M. Egan Source Type: research

Type 1 Diabetes and Aging
The number of older adults with type 1 diabetes (T1D) is increasing due to an overall increase in life expectancy and improvement in diabetes management and treatment of complications. They are a heterogeneous cohort due to the dynamic process of aging and the presence of comorbidities and diabetes-related complications. A high risk for hypoglycemia unawareness and severe hypoglycemia has been described. Periodic assessment of health status and adjustment of glycemic goals to mitigate hypoglycemia is imperative. Continuous glucose monitoring, insulin pump, and hybrid closed-loop systems are promising tools to improve glyce...
Source: Endocrinology and Metabolism Clinics of North America - February 16, 2023 Category: Endocrinology Authors: Elena Toschi Source Type: research

Perspectives on Prediabetes and Aging
Diabetes prevention programs (DPPs) have been shown to effectively delay, and sometimes prevent, the progression from prediabetes to diabetes; however, labeling someone with prediabetes comes with potential negative psychological, financial, and self-perception consequences. Many older adults with prediabetes nowadays have a relatively “low-risk” form of prediabetes that rarely progresses to diabetes and may regress to normoglycemia. In this article, we review the impact of aging on glucose metabolism and provide a holistic approach to cases of prediabetes in older adults that maximizes the benefit–risk balance of in...
Source: Endocrinology and Metabolism Clinics of North America - February 16, 2023 Category: Endocrinology Authors: Mohammed E. Al-Sofiani, Alanood Asiri, Sarah Alajmi, Walid Alkeridy Source Type: research

Male Reproduction and Aging
Recent publications of well-conducted population studies have informed us that the syndromic prevalence of age-related low testosterone, also known as late-onset hypogonadism, is quite low. Several well-conducted trials in middle-aged and older men with age-related decline in testosterone levels have revealed that efficacy of testosterone therapy is modest with improvement in sexual function, mood, volumetric bone density, and anemia. Although select older men might benefit from testosterone therapy, its effect on prostate cancer risk and major adverse cardiovascular events remains unclear. The results of the ongoing TRAVE...
Source: Endocrinology and Metabolism Clinics of North America - February 16, 2023 Category: Endocrinology Authors: Maria Gabriela Figueiredo, Thiago Gagliano-Juc á, Shehzad Basaria Source Type: research

Time to Rethink Diabetes Care
The American Diabetes Association and an international group of experts published a consensus report in August 2021 proposing an “HbA1c (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 7, 2023 Category: Endocrinology Authors: Betul A. Hatipoglu Tags: Preface Source Type: research

Remission with an Intervention
Long-term remission of type 2 diabetes following lifestyle intervention or pharmacotherapy, even in patients with mild disease, is rare. Long-term remission following metabolic surgery however, is common and occurs in 23% to 98% depending on disease severity and type of surgery. Remission after surgery is associated with excellent glycemic control without reliance on pharmacotherapy, improvements in quality of life, and major reductions in microvascular and macrovascular complications. For patients with type 2 diabetes, early intervention with metabolic surgery, when beta cell function still remains intact, provides the gr...
Source: Endocrinology and Metabolism Clinics of North America - February 7, 2023 Category: Endocrinology Authors: Zubaidah Nor Hanipah, Francesco Rubino, Philip R. Schauer Source Type: research