Antithyroid drug therapy of Graves' hyperthyroidism: realistic goals and focus on evidence.
Authors: Laurberg P, Andersen S, Karmisholt J Abstract Only a minority of patients with hyperthyroidism caused by Graves' disease will experience cure of disease with a permanent euthyroid state without medication. Antithyroid drugs are useful in attaining euthyroidism, and most patients will gradually enter remission of the autoimmune abnormality after becoming euthyroid. A stable euthyroid state may be sustained by prolonged low-dose medication. The risk of relapse of hyperthyroidism after withdrawal of medication seems to be independent of duration of therapy, once remission has been induced. A number of risk fa...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Diagnosis and management of congenital adrenal hyperplasia.
Authors: Speiser PW Abstract Congenital adrenal hyperplasia is the name applied to a class of autosomal recessive disorders resulting from deficiency of one of five enzymes necessary for cortisol synthesis by the adrenal cortex. Congenital adrenal hyperplasia is most often attributable to steroid 21-hydroxylase deficiency, accounting for more than 90% of cases. This discussion will be limited to the most common form of the disease, highlighting methods of diagnostic screening and challenges in disease management. PMID: 30743773 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Effect of systemic glucocorticoid therapy on bone metabolism: an update.
Authors: Cooper MS Abstract Glucocorticoids are widely used for a range of inflammatory conditions. However, their use is complicated by significant side effects. The most important of these from a clinical point of view is on bone, where glucocorticoids substantially increase the risk of osteoporosis and fracture. This review will give an overview of the pathophysiologic basis and epidemiology of glucocorticoid-induced osteoporosis, examine diagnostic and therapeutic approaches currently available, and suggest the likely impact of the most recent scientific, clinical and pharmaceutical advances. Glucocorticoids im...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Diagnosis, misdiagnosis and management of hyperprolactinemia.
Authors: Healy ML, Smith TPP, McKenna TJ Abstract Hyperprolactinemia is a commonly encountered disorder that suppresses both male and female gonadal function. The etiology includes pituitary tumors, hypothalamic or pituitary stalk lesions, drugs and hypothyroidism. In women, the hyperprolactinemic syndrome is characterized by menstrual disorders with or without galactorrhea, while men present with hypogonadism and related symptoms. Occasionally, a pituitary macroadenoma may be associated with pressure symptoms and/or hypopituitarism. Clinically, the most important cause of hyperprolactinemia is a prolactin-secretin...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Role of gonadotropin-releasing hormone II in the mammalian nervous system.
Authors: Kauffman AS, Rissman EF Abstract Gonadotropin-releasing hormone (GnRH) is a small neuropeptide of which there are multiple structural variants. The first variant identified in mammals, GnRH I, controls the release of pituitary gonadotropins. More recently, a second isoform, GnRH II, first isolated in the bird, was identified in the mammalian brain and periphery. Although it is unlikely to be a primary regulator of gonadotropin release, GnRH II appears to have a wide array of physiological and behavioral functions. GnRH II-containing fibers are present in several nuclei known to regulate reproduction and/or...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Balancing bone health and mental health: a new clinical dilemma?
Authors: Haney EM PMID: 30743777 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Study suggests diabetes risk increased with a high-carb diet in women.
Authors: PMID: 30743778 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Role of adipose hypoxia in endocrine alterations: a possible new anti-inflammatory therapeutic target in obesity?
Authors: Ye J Abstract Dr Jianping Ye is a Professor at the Pennington Biomedical Research Center, Louisiana State University (LA, USA). He completed his graduate education in the medical school, Beijing University (China) in 1989 and moved to the USA to undertake postdoctoral research in 1992. He conducted research in the role of inflammation in cancer and was an instructor at the Health Science Center at San Antonio, University of Texas (TX, USA) in 1997, and assistant professor in the West Virginia University (WV, USA) in 1999. In 2001, he set up his lab at the Pennington Biomedical Research Center, Louisiana St...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Initial combination therapy with sitagliptin, a dipeptidyl peptidase-4 inhibitor, and metformin for patients with Type 2 diabetes mellitus.
This article reviews initial treatment with Janumet as an alternative to monotherapy. PMID: 30743780 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Is obesity contagious?
Authors: Lopez R Abstract Evaluation of: Christakis N, Fowler J. The spread of obesity in a large social network over 32 years. N. Engl. J. Med. 357(4), 370-379 (2007). A recent article using longitudinal data from the Framingham Heart Study found that weight gain was similar between friends. The influence of friends was found to be stronger than that of siblings or spouses. If this association reflects an underlying relationship, it implies that social norms, shared experiences and similar environments might be more important in weight gain than underlying strict biologic or genetic factors. It may also imply that...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Risk of diabetes insipidus after pituitary surgery.
Authors: Woods C, Thompson CJ Abstract Diabetes insipidus is a common complication of pituitary surgery, occurring acutely in 18-30% of operations. Most patients recover full posterior function but a minority sustain sufficient damage to vasopressin-secreting neurons to develop permanent diabetes insipidus. The triplephase response, comprising early transient diabetes insipidus, followed by a period of antidiuresis and hyponatremia, before resolving into permanent diabetes insipidus, is an uncommon but important variant. Diabetes insipidus is more common following surgery for craniopharyngioma compared with pituita...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Inflammatory biomarkers associated with obesity and insulin resistance: a focus on lipocalin-2 and adipocyte fatty acid-binding protein.
Authors: Hoo RL, Yeung DC, Lam KS, Xu A Abstract Obesity is an important risk factor for a cluster of metabolic and cardiovascular diseases, including insulin resistance, Type 2 diabetes, nonalcoholic fatty liver disease and atherosclerosis. Systemic low-grade inflammation, characterized by elevated circulating concentrations of proinflammatory factors, has recently been proposed to be a key mediator that links obesity with its medical complications. Adipose tissue is now recognized as the major contributor to systemic inflammation associated with obesity. As obesity develops, adipose tissue is infiltrated with act...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Role of IGF-I in Type 2 diabetes: a focus on the mouse model.
Authors: Landau D, Segev Y Abstract Insulin resistance, the key mechanism in Type 2 diabetes mellitus (T2DM) is also associated with the deregulation of other glucose homeostasis pathways, such as the growth hormone (GH)-IGF-I system. In this review, we summarize the endocrine and renal GH-IGF axis changes in db/db mice, a model of T2DM, and compare it with the nonobese diabetic mouse model of T1DM. In the latter, elevated circulating GH levels (associated with kidney disease) could be ameliorated with the use of GH antagonists. Contrary to that, in the obese db/db mice, serum GH and IGF-I levels are decreased and ...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

β-cell regeneration to treat Type 1 diabetes mellitus.
β-cell regeneration to treat Type 1 diabetes mellitus. Expert Rev Endocrinol Metab. 2008 Jan;3(1):51-60 Authors: Barra Couri CE, Foss-Freitas MC, Foss MC, Voltarelli JC Abstract Type 1 diabetes mellitus (T1DM) results from the autoimmune destruction of the insulin-producing pancreatic β-cells. The autoimmune response begins years before the presentation of hyperglycemic symptoms. At the time of clinical diagnosis, less than 30% of β-cell mass still remains. The conventional therapeutic option to T1DM is daily insulin injections, which is shown to promote tight glucose control and reduce ...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Adipokines: linking obesity and cardiovascular disease.
Authors: Bell-Anderson KS Abstract Obesity is fast becoming one of the most important contributors to cardiovascular disease. Adipose tissue is gaining recognition as a key endocrine organ that secretes a growing number of adipokines, linking adiposity with inflammation, endothelial dysfunction and the initiation of atherosclerosis. In particular, accumulation of visceral adipose tissue is implicated in the development of cardiovascular disease as it is associated with increased macrophage infiltration and oversecretion of proinflammatory and prothrombotic factors, such as TNF-α, IL-6, plasminogen activator i...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Current and future perspectives on recombinant growth hormone for the treatment of obesity.
Authors: Rixhon M, Tichomirowa MA, Tamagno G, Daly AF, Beckers A Abstract The similarities between patients with untreated growth hormone (GH) deficiency and those with the cardiometabolic syndrome and the beneficial effects of recombinant human GH (rhGH) on body composition have led to the hypothesis that rhGH treatment may have utility in obesity. GH release is reduced in the setting of obesity, primarily due to hyperinsulinism and increased free fatty acid levels. We reviewed the outcomes of 23 clinical studies carried out between 1987 and 2006 that examined the effects of rhGH administration in the obese state....
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Notch-Hes signaling in pituitary development.
Authors: Hojo M, Kita A, Kageyama R, Hashimoto N Abstract The pituitary gland is a critical endocrine organ that controls homeostasis, metabolism, reproduction and growth. Pituitary organogenesis involves the initial proliferation process of progenitor cells and the subsequent differentiation process into distinct cell types. Although various signaling molecules and transcription factors play roles in the pituitary development, the mechanisms that control progenitor cells remain to be elucidated. The mammalian Hes basic helix-loop-helix genes, known as Notch effectors, play essential roles in the development of var...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Therapeutic potential of ghrelin in cardiac diseases.
Authors: Kishimoto I, Tokudome T, Schwenke DO, Takeshi S, Hosoda H, Nagaya N, Kangawa K Abstract It has recently been revealed that ghrelin, a hormone discovered in the stomach, has a potential therapeutic role in the treatment of diseased hearts. In human patients with heart failure and in animal models, repeated subcutaneous administration of ghrelin improves cardiac dysfunction and remodeling. Moreover, ghrelin treatment early after myocardial infarction effectively reduces fatal arrhythmia and, consequently, mortality. The beneficial effects of ghrelin result from a growth hormone increase, an orexigenic effect...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Addison's disease and hypertransaminasemia.
Authors: Kalambokis G, Milionis HJ Abstract Endocrine diseases, such as diabetes mellitus and thyroid dysfunction, have been rarely associated with increased serum transaminase activity. The association of Addison's disease with abnormal liver function tests has received less attention. Addison's disease as a part of autoimmune polyglandular syndrome-1 may be associated with autoimmune hepatitis. Addison's disease may also coexist with celiac disease, an autoimmune disorder commonly associated with hypertransaminasemia. On the other hand, a number of case reports have suggested hypertransaminasemia to be one of the...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Genetics of hereditary hemochromatosis: a clinical perspective.
Authors: Gan EK, Trinder D, Ayonrinde OT, Olynyk JK Abstract Hereditary hemochromatosis due to homozygosity for the C282Y mutation in the HFE gene product is the most common autosomal recessive genetic disorder in populations of northern European descent, where it attains a maximum prevalence of approximately one in 200. Cross-sectional and longitudinal studies have revealed that clinically significant iron-overload disease develops in at least 28% of male and 1% of female HFE C282Y homozygotes. The relatively low clinical penetrance is largely unexplained. Current evidence suggests a limited role for digenic inher...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Substrate-reduction therapy with miglustat for glycosphingolipid storage disorders affecting the brain.
Authors: Lachmann RH Abstract A number of lysosomal storage disorders (LSDs) are characterized by glycosphingolipid (GSL) storage in the brain. Although enzyme-replacement therapy is an effective treatment for the visceral manifestations of some of these disorders, this approach has not, to date, been useful in CNS disease. Substrate reduction therapy (SRT) is an alternative approach to treatment in which the aim is to reduce the rate of synthesis of GSL to a level where the residual enzyme activity in the affected cell can prevent lysosomal storage. Miglustat, an iminosugar, is an inhibitor of the first step of GS...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Switching fat from the periphery to bone marrow: why in Type I diabetes?
Authors: McCabe LR PMID: 30743793 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

A link between depression and bone metabolism: what are the implications for treatment?
Authors: Mezuk B, Golden SH PMID: 30743795 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Short stature homeoboxcontaining gene and idiopathic short stature.
Authors: Iughetti L, Appio P, Capone L, Madeo S, Predieri B, Balli F, Forabosco A Abstract The term idiopathic short stature (ISS) refers to patients who are short due to various unknown reasons. Although it is clear that multiple factors contribute to final height, genetic factors play a crucial role. Mutations of a human homeobox gene, short stature homeobox-containing (SHOX) gene, have been shown to be associated with the short stature phenotype in patients with Turner syndrome, most patients with Leri-Weill dyschondrosteosis and some cases of ISS. The prevalence of SHOX anomalies in subjects previously recogniz...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Pituitary-directed medical treatment of Cushing's disease.
Authors: Arnaldi G, Cardinaletti M, Trementino L, Tirabassi G, Boscaro M Abstract The treatment of Cushing's disease is very complex and represents a challenge for clinicians. Transphenoidal surgical excision of adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma remains the treatment of choice but, unfortunately, the rate of cure at long-term follow-up is suboptimal and recurrences are high, even in the hands of skilled neurosurgeons. Other treatment options, such as bilateral adrenalectomy and pituitary radiotherapy, are currently in use but no treatment has proven fully satisfactory during the lengthy...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Role of TNF- α in human female reproduction.
Role of TNF-α in human female reproduction. Expert Rev Endocrinol Metab. 2009 May;4(3):273-282 Authors: Calleja-Agius J, Muttukrishna S, Jauniaux E Abstract TNF-α is a highly versatile cytokine, playing an important role in both apoptosis and inflammation, which is central to reproduction. It belongs to the Th1 type of cytokines. Thus, TNF-α is a proinflammatory cytokine and is involved during follicle development and ovulation, corpus luteum formation and regression and cyclic endometrium function. It has been postulated to be detrimental to the survival of the conceptus due to apopt...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Should we use statins in treatment of polycystic ovary syndrome?
Authors: Duleba AJ, Pawelczyk L PMID: 30743799 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Turner syndrome: update on current therapies.
Authors: Bondy C Abstract New treatments for girls and women with Turner syndrome (monosomy X) have dramatically improved their quality of life and health. Young girls are treated with growth hormone to enhance adult height, and with estrogen to induce and maintain feminization, and prevent osteoporosis. Vigilant screening for otitis, thyroid disease, hypertension, dyslipidemia and diabetes allows for early and effective medical treatment of these common problems. Comprehensive cardiovascular evaluation and regular monitoring of aortic diameter are essential to identify individuals at risk for dissection or rupture...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Inhaled insulin: a clinical perspective with emphasis on EXUBERA ®.
Inhaled insulin: a clinical perspective with emphasis on EXUBERA®. Expert Rev Endocrinol Metab. 2007 May;2(3):313-320 Authors: Norwood P Abstract There is a Type 2 diabetes epidemic; however, unfortunately, even though insulin is an effective therapy, it is mostly used late and as a last resort. Type 1 diabetics find it difficult to administer extra insulin injections when needed owing to the inconvenience and, although most cope well, many dislike injecting themselves so frequently. The newly approved EXUBERA® inhaled insulin should help counteract the resistance of patients and physicians in ...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Fixed-dose combination of pioglitazone and glimepiride in the treatment of Type 2 diabetes mellitus.
Authors: Forst T, Pfützner A Abstract Type 2 diabetes is characterized by impaired insulin sensitivity and disturbances in β-cell function. While glimepiride stimulates β-cell secretion and leads to a reduction of blood glucose levels, pioglitazone activates peroxisome proliferator-activated receptor-γ and improves insulin resistance. Combining these two modes of action has been shown to improve glucose and lipid metabolism, and to improve the overall cardiovascular risk in patients with Type 2 diabetes. The combination of glimepiride and pioglitazone is generally well tolerated and a fixed com...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Molecular pathogenesis of renal pseudohypoaldosteronism type 1.
Authors: Riepe FG Abstract Pseudohypoaldosteronism is a rare heterogeneous syndrome of mineralocorticoid resistance resulting in insufficient potassium and hydrogen secretion. Pseudohypoaldosteronism type 1 is characterized by mineralocorticoid resistance leading to neonatal salt loss, dehydration and failure to thrive. At least two different forms of pseudohypoaldosteronism type 1 can be distinguished, showing either a systemic or renal form of mineralocorticoid resistance. This review offers an overview on transepithelial sodium reabsorption and pseudohypoaldosteronism in general, and focuses on the underlying mo...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Osteoporosis risk assessment by dentists: a new pathway for access to therapy?
Authors: Horner K, Devlin H PMID: 30743804 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Management of hypertension in diabetes mellitus.
Authors: Alzahrani AS Abstract Overall, approximately 40% of diabetic patients have hypertension at the time of diagnosis of diabetes and a similar percentage may develop hypertension during their follow-up. Factors contributing to this high prevalance of hypertension in diabetes include obesity, old age, insulin resistance, increased extracelluar volume, diabetic nephropathy and increased arterial stiffness. Well-conducted clinical trials that have been completed in the last decade demonstrated a major impact of hypertension on the micro- and macrovascular complications of diabetes and remarkable benefits of its c...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Familial pheochromocytomas and paragangliomas associated with mutations of the succinate dehydrogenase genes.
Authors: Timmers HJ, Pacak K Abstract Pheochromocytomas and other sympathetic paragangliomas are rare tumors of the adrenal gland or extra-adrenal chromaffin tissue. Mutations of the genes encoding three subunits of the mitochondrial enzyme succinate dehydrogenase give rise to hereditary paraganglioma. We will review the distinct clinical phenotypes of familial paraganglioma syndromes associated with mutations in genes encoding for three different subunits of succinate dehydrogenase. The current insights in optimal strategies for biochemical testing, tumor localization and therapy of paraganglioma will be discussed...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

New development in intracrinology of breast carcinoma: therapeutic horizons after aromatase inhibitors.
Authors: Sasano H, Miki Y, Fukuda T, Nagasaki S, Nakata T, Suzuki T Abstract Aromatase inhibitors have become the gold standard of endocrine therapy in postmenopausal patients with estrogen receptor-positive or estrogen-dependent breast carcinoma, replacing tamoxifen. However, it is true that there are some potential problems to be overcome or improved on regarding aromatase inhibitor treatment of breast cancer. This especially includes the presence of the estrogen receptor-positive patients who do not necessarily respond to aromatase inhibitors, may require other modes of endocrine therapy and develop resistance t...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Cardiometabolic risk factors and their treatment in patients with Type 2 diabetes.
Authors: Kumar S Abstract The prevalence of obesity-associated diabetes is increasing dramatically in the UK and worldwide. Obesity, particularly abdominal obesity, is not only associated with other cardiovascular risk factors, but is an independent cardiometabolic risk factor for diabetes and cardiovascular disease. Thus, the focus of obesity management, especially in patients with prediabetes and Type 2 diabetes, should encompass cardiometabolic risk reduction as well as weight loss. Lifestyle and diet modification should form the basis of all effective strategies for weight reduction. Pharmacotherapy provides an...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Gonadotropin and its role in the β-catenin/T-cell factor signaling pathway.
Gonadotropin and its role in the β-catenin/T-cell factor signaling pathway. Expert Rev Endocrinol Metab. 2007 May;2(3):375-385 Authors: Pon YL, Wong AS Abstract Gonadotropins, follicle-stimulating hormone and luteinizing hormone are key regulators in ovarian function, acting in an endocrine manner to regulate gametogenesis and steroidogenesis. In addition to normal tissue, gonadotropin receptors have also been demonstrated in ovarian carcinoma cell lines and primary tumors, suggesting that the gonadotropins may play a role in the pathophysiology of ovarian cancer. Thus, understanding mechanisms in...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Stem cells offer hope for Type I diabetes sufferers.
Authors: PMID: 30743810 [PubMed] (Source: Expert Review of Endocrinology and Metabolism)
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Role of protein kinase C inhibition in the development of diabetic microvascular complications.
Authors: Skljarevski V, Ferdinand SJ, Kles KA Abstract Diabetes mellitus affects millions of people in the USA and throughout the world. The global epidemic may be attributed to both the increasing age of the population and the increasing rates of obesity. Diabetes is associated with chronic microvascular (diabetic neuropathy, retinopathy and nephropathy) and macrovascular complications (heart disease, stroke and peripheral vascular disease). Patients with diabetes benefit from a comprehensive approach to prevent complications, including weight loss, smoking cessation, antiplatelet agents, and glycemic and blood pr...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

In search of neuroprotective therapies based on the mechanisms of estrogens.
Authors: DonCarlos LL, Azcoitia I, Garcia-Segura LM Abstract Although estradiol is a neuroprotective factor, estrogen therapy in older women increases the risk of adverse cognitive outcomes and poses additional peripheral risks, requiring careful use of estrogenic compounds as treatments for neurodegenerative conditions or neural injury. Potential alternatives to estrogen therapy to promote neuroprotection might include treatment with molecules that are able to interact with estrogen receptors, with alternative mechanisms of action, or with molecules that induce local estradiol synthesis in the brain, or a combinat...
Source: Expert Review of Endocrinology and Metabolism - February 15, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Understanding and managing secondary osteoporosis.
Authors: Colangelo L, Biamonte F, Pepe J, Cipriani C, Minisola S Abstract INTRODUCTION: The term secondary osteoporosis (SO) identifies a reduction of bone mass related to a well-established disease or pharmacological agent. The identification of the underlying disease often represents a challenging situation in clinical practice. Areas covered: The prevalence of SO in the real world may vary, ranging from 17% to 80%; therefore, search for a form of SO represents a pillar when evaluating patients with osteoporosis. Guidelines for treatment of specific secondary forms of osteoporosis, such as glucocorticoid-induced ...
Source: Expert Review of Endocrinology and Metabolism - February 9, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Fixed-dose combination of ertugliflozin and metformin hydrochloride for the treatment of type 2 diabetes.
Authors: Frias JP Abstract INTRODUCTION: Combining antihyperglycemic agents in order to rapidly and safely achieve the best possible glycemic control is the standard of care today for the management of type 2 diabetes. Agents should ideally have mechanisms of actions that are complementary and that improve glycemic control without unacceptable gain in body weight or hypoglycemia. Areas covered: Ertugliflozin and metformin hydrochloride (ertugliflozin/metformin, SEGLUROMET) is a recently approved fixed-dose combination tablet containing the sodium-glucose co-transporter 2 (SGLT-2) inhibitor ertugliflozin and metform...
Source: Expert Review of Endocrinology and Metabolism - February 8, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

An update on clinical care for pregnant women with acromegaly.
Authors: Chanson P, Vialon M, Caron P Abstract INTRODUCTION: As pregnancy is rare in women with acromegaly, only case reports and few series have been published. Areas covered: All case reports and publications dealing with pregnancy in patients with acromegaly were collated. Information concerning the effects of acromegaly on pregnancy outcomes, the impact of pregnancy on GH/IGF-I measurements, acromegaly comorbidity and pituitary adenoma size, the effects of treatment of acromegaly on fetus outcomes were retrieved and analyzed. Expert commentary: Based on the small number of reported cases, pregnancy is generally...
Source: Expert Review of Endocrinology and Metabolism - February 1, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Endoscopic management of weight regain following Roux-en-Y gastric bypass.
Authors: Hourneaux De Moura DT, Thompson CC Abstract INTRODUCTION: With the cumulative increase in the number of patients undergoing bariatric surgery, postoperative weight regain has become a considerable challenge. Mechanisms for weight regain are not fully understood and the process is likely multifactorial in many cases. Endoluminal revisions that reduce gastric pouch size and diameter of the gastrojejunal anastomosis may offer an effective and less invasive management strategy for this population. Areas covered: We critically review data from case series, retrospective and prospective studies, and meta-analyse...
Source: Expert Review of Endocrinology and Metabolism - January 30, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Evaluation and management of ketosis-prone diabetes.
This article reviews the Aß classification scheme ('A' for autoantibody status and 'ß' for beta cell functional reserve) which accurately delineates subgroups of KPD, and addresses the relevance of defining these subgroups for clinical outcomes and long-term insulin dependence. Subsequently, the detailed evaluation and management of KPD patients after their index DKA episode is described. Expert commentary: Among patients presenting with DKA, it is important to diagnose specific subgroups of KPD and not assume that they represent exclusively patients with autoimmune type 1 diabetes. The Aß classification ...
Source: Expert Review of Endocrinology and Metabolism - January 9, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Surgical-pharmacological interactions in the treatment of acromegaly.
Authors: Abreu C, Guinto G, Mercado M Abstract INTRODUCTION: Acromegaly requires a multimodal treatment approach that includes surgery by an expert pituitary neurosurgeon, pharmacological treatment with one or more of the available drugs and radiation therapy. These treatment alternatives are not mutually exclusive but rather complement each other when properly indicated in the individual patient. In this review, we summarize and analyze the available data concerning the choice of the surgical approach (microscopy vs. endoscopy) and the interactions between medical treatment with somatostatin analogs and pituitary ...
Source: Expert Review of Endocrinology and Metabolism - January 2, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Long-term effects on growth, development, and metabolism of ALL treatment in childhood.
Authors: Bruzzi P, Bigi E, Predieri B, Bonvicini F, Cenciarelli V, Felici F, Iughetti L Abstract INTRODUCTION: One aim of the long-term care in survivors from acute lymphoblastic leukemia (ALL) during childhood is to avoid or limit complications caused by aggressive therapeutic strategies. Areas covered: ALL survivors are a heterogeneous group according to therapeutic protocols. In the last decades, cranial radiotherapy (cRT) has been largely replaced by intrathecal chemotherapy (CT) with a reduction of endocrine sequelae. Published studies are generally difficult to be interpreted because patients were treated acc...
Source: Expert Review of Endocrinology and Metabolism - January 2, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Management of hyponatremia: causes, clinical aspects, differential diagnosis and treatment.
Authors: Peri A Abstract INTRODUCTION: Hyponatremia is the most frequent electrolyte disorder in hospitalised patients. Acute and severe hyponatremia may be a life-threatening situation. However, also mild and chronic hyponatremia may negatively affect the health status (i.e. gait disturbances, attention deficits, falls and fractures, and bone loss) and may increase the risk of death. Therefore, it is of paramount importance for clinicians to have an in-depth knowledge on this topic, in order to appropriately manage patients affected by hyponatremia. Areas covered: This review will cover different areas related to ...
Source: Expert Review of Endocrinology and Metabolism - January 2, 2019 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Cardiometabolic risks in PCOS: a review of the current state of knowledge.
Authors: Kakoly NS, Moran LJ, Teede HJ, Joham AE Abstract INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting up to 18% women of reproductive age. It is associated with a range of metabolic, reproductive, and psychological features. Current evidence indicates a role of PCOS in the development of metabolic and increased cardiovascular risk factors (CVRF) with implications for compromised cardiovascular endpoint disease, which may have a considerable impact on health and health care costs. Areas covered: Existing studies examining long-term cardiometabolic health in PCOS are hetero...
Source: Expert Review of Endocrinology and Metabolism - December 19, 2018 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

Diet and prevention of type 2 diabetes mellitus: beyond weight loss and exercise.
Authors: Palacios OM, Kramer M, Maki KC Abstract INTRODUCTION: Insulin resistance (IR) and pancreatic beta-cell dysfunction are core pathophysiologic features of type 2 diabetes mellitus (T2DM). Select lifestyle and pharmacologic interventions, including weight loss, physical activity, a Mediterranean diet intervention, and hypoglycemic agents, have been shown to prevent or delay T2DM. However, dietary factors other than weight loss may also impact risk, mainly through effects to enhance insulin sensitivity, although some may also directly or indirectly impact pancreatic beta-cell function. Areas covered: A literat...
Source: Expert Review of Endocrinology and Metabolism - December 9, 2018 Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research