The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 2 16a
Copyright © 2005 by The Endocrine Society
Endocrinology & Metabolism News February 2005
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Endocrine Discovery
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The effectiveness of four popular diets (Atkins, Zone, Weight Watchers, and Ornish) was assessed in a randomized controlled trial, which showed that at one year 1) extent of weight loss (3–5 kg) was associated with self-reported adherence, but not the particular diet type; and 2) lowering of total/HDL cholesterol, C-reactive protein, and insulin were associated with extent of weight loss, with no difference between diets. There was no significant decrease in blood pressure or fasting glucose.
(JAMA (Jan. 5) 2005;293:43)[Abstract/Free Full Text]
The long-term impact of gastric surgery for obesity on weight, lifestyle, diabetes, and cardiovascular risk factors were compared with conventional medical treatment in a large prospective, controlled trial. After bariatric surgery, weight fell by 23% and 16% at 2 and 10 years, respectively; whereas it rose in controls. Operated patients had lower energy intake and were more physically active. Recovery from diabetes, hypertriglyceridemia, low HDL-cholesterol, and hypertension occurred more often after surgery.
(NEJM (Dec. 23) 2004;351:2683)[Abstract/Free Full Text]
In a cohort of perimenopausal women, frequent anovulatory cycles despite estrogen peaks equivalent to those resulting in LH surges in younger women suggests that hypothalamic-pituitary insensitivity to estrogen plays a role in the menopause.
(JAMA (Dec. 22) 2004;292:2991)[Abstract/Free Full Text]
Among 50,613 men with prostate cancer and surviving five years, those receiving androgen-deprivation therapy had significantly more fractures: 19.4% vs. 12.6%.
(NEJM (Jan. 13) 2005;352:154)[Abstract/Free Full Text]
A blood glucose level >270 mg/d was associated with impaired cognitive performance in 50% of patients with diabetes.
(Diabetes Care 28:71, 2005)[Abstract/Free Full Text]
NHANES subjects who consumed <20 drinks of alcohol per month were less likely to have the metabolic syndrome than nondrinkers.
(Diabetes Care 27:2954, 2004)[Abstract/Free Full Text]
A novel adipocytokine, named visfatin, is secreted by visceral fat, binds the insulin receptor, and mimics the hypoglycemic effect of insulin.
(Science 2004 Dec 16; [Epub] Fukuhara A, et al. PMID: 15604363)
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Endocrine Practice
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The Centers for Medicare and Medicaid Services announced expanded Medicare coverage for diabetes screening with fasting and post-glucose challenge glucose measurements. This benefit is available to individuals who have 1) BMI 
30, previous elevated fasting glucose or glucose intolerance, dyslipidemia, or hypertension; or 2) any two of the following: BMI >25 but <30, family history of diabetes, age 65 years or older, or history of gestational diabetes or baby weighing >9 lbs.
Pregabalan became the first FDA-approved drug for painful peripheral neuropathy. In three double-blind, placebo-controlled trials, the drug provided rapid and ‘clinically meaningful’ relief in a significant portion of patients. (http://www.lyrica.com)
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Endocrine Policy
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The National Academy of Sciences issued a report on risks of perchlorate exposure, finding no evidence of adverse effects on human thyroid function from concentrations far greater than 20 mcg/liter, which it proposed as the safe level for drinking water. This is 20-fold higher than the proposed EPA limit of 1 mcg/liter in drinking water. (http://books.nap.edu/catalog/11202.html)
The U.S. Departments of Agriculture and Health and Human Services issued updated dietary guidelines recommending 5–13 daily servings of fruits and vegetables, 20–35% of calories as fat, and less sugar and salt, as well as one hour of moderate to strenuous physical activity per day. (http://www.healthierus.gov/dietaryguidelines)
A National Academy of Sciences report for students and the lay public, "Science, Medicine, and Animals," explains the importance of animals in biomedical research. The paper describes the history of animal research, examples of medical advances dependent on animal models, regulations and oversight for animal use, and initiatives to perform animal research more humanely and efficiently. (http://books.nap.edu/catalog/10733.html)
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Endocrine Education & Training
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An online interactive curriculum designed to help fellowship programs satisfy ACGME requirements for teaching professionalism and communication is available through Virtual Mentor, the AMA’s online Ethics Journal. (http://www.ama-assn.org/ama/pub/category/3040.html)
In anticipation of the new ACGME requirement for Core Competency assessment, which will be effective in July 2005, APDEM is collecting examples of teaching methods and evaluation tools that endocrine training programs are introducing to satisfy this requirement. Best practices will be added to the revised "APDEM Recommendations for Training in Endocrinology, Diabetes and Metabolism." (Submit suggestions to Dr. Debra Simmons: SimmonsDebraL@uams.edu)
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Endocrine Research Funding
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The NIH is seeking applications for the second annual NIH Director’s Pioneer Award (NDPA) Program, designed to support individual scientists of exceptional creativity who propose pioneering approaches to major contemporary challenges in biomedical research not already supported by other mechanisms. The program will fund between 5–10 awards of up to $500,000 in direct costs per year for 5 years. (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-05-021.html)
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Endocrinologists
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Stefan Bornstein will become Medicine chair at the University of Dresden.
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Milestones in Endocrinology
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One hundred years ago, Ernest Starling first used the term ’hormone’ to describe ’chemical messengers’ in his lecture "On the Chemical Correlation of the Functions of the Body" at the Royal College of Physicians. The word was derived from the Greek verb hormao, meaning to arouse or excite.
Fifty years ago, Jerome Conn described "Primary aldosteronism: a new clinical syndrome," characterized by hypokalemic alkalosis, hypertension, intermittent tetany, and periodic weakness. He observed that the condition was usually caused by a benign adrenocortical adenoma.
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In the Journal 25 Years Ago
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Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. Burghen GA, Givens JR, and Kitabchi AE.
J Clin Endocrinol Metab 1980:50;113–116
. "A significant correlation was found between plasma insulin response areas and plasma testosterone...in PCOD patients. These studies demonstrate that hyperandrogenism correlates with hyperinsulinism."
Simulation of the normal menstrual cycle in Kallman’s syndrome by pulsatile administration of luteinizing hormone-releasing hormone (LHRH). Crowley Jr WF, and McArthur JW.
J Clin Endocrinol Metab 1980:51;173–175
. "The administration of small doses of LHRH at 2-hourly intervals over a 27 day period to a 24-year old patient with Kallman’s syndrome resulted in ovulation as indicated by: (1) a biphasic temperature response, (2) anatomical changes in the ovaries demonstrated by ultrasound, and (3) the pattern of circulating gonadotropin and gonadal steroid concentrations."
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