The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 7 17a
Copyright © 2005 by The Endocrine Society
Endocrinology & Metabolism News, July 2005
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Endocrine Discovery
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The U.S. Preventive Services Task Force recommended against routine use of either combined estrogen and progestin, or unopposed estrogen to prevent chronic conditions in postmenopausal women after hysterectomy, based on results of the Women’s Health Initiative and a 2002 summary of relevant evidence
(Ann Int Med (May 17, 2005) 2005;142:855)[Abstract/Free Full Text]
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For evidence summary, see http://www.preventiveservices.ahrq.gov.
Oxytocin increased trust in humans, specifically affecting individuals’ acceptance of social risks in interpersonal interactions.
(Nature (June 2, 2005) 435:673)[CrossRef][Medline]
Pioglitazone decreased carotid intima-media thickness independently of glycemic control in type 2 diabetes patients over six months in a controlled randomized trial.
(Circulation (May 17, 2005) 111:2525)[Abstract/Free Full Text]
Anti-CD3 monoclonal antibody treatment started within 6 weeks after diagnosis of type 1 diabetes preserved C-peptide responses to a mixed meal for 1 year, with further significant improvement up to 2 years after treatment, accompanied by lower plasma HbA1c and insulin requirements.
(Diabetes (May 2005) 54:1763)[Abstract/Free Full Text]
Pancreas transplant, by restoring sustained normoglycemia, improved diabetic nephropathy
(Diabetes Care (June 2005) 28:1366)[Abstract/Free Full Text]
and retinopathy
(Transpl Int (May 2005) 18(5):619)
compared to the status of these complications in an untransplanted group of patients with diabetes.
Mice with a homozygous mutation in clock, a key transcription factor in the molecular circadian clock within hypothalamic pacemaker neurons, were hyperphagic and obese and developed a metabolic syndrome-like constellation of hyperleptinemia, hyperlipidemia, hepatic steatosis, hyperglycemia, and hypoinsulinemia.
(Science (May 13, 2005) 308(5724):1043)
Transient exposure of maternal rats during the period of gestation when fetal gonadal sex determination occurs resulted in decreased sperm number and viability in adult males in the F1 generation, an abnormality that was then transferred through the male germ line to most males in subsequent F1 to F4 generations. This effect correlated with altered germ line DNA methylation patterns, suggesting an environmental factor can reprogram the germ line and promote a transgenerational disease state.
(Science (June 3, 2005) 308(5727):1466)
In the nonobese diabetic (NOD) mouse, a specific proinsulin and insulin sequence was identified as a primary target of the autoimmunity causing diabetes, based on studies abrogating this response in insulin 1 and 2 gene knockout mice with a mutated proinsulin transgene containing a single B chain residual change.
(Nature (May 12, 2005) 435:220)
Cloned T cells from lymph nodes draining the pancreas in type 1 diabetes patients demonstrated a high degree of clonal expansion, and in those with the DR4 susceptibility allele recognized the insulin A 1—15 epitope restricted by DR4—consistent with an insulin role as the target antigen leading to autoimmune diabetes.
(Nature (May 12, 2005) 435:224)[CrossRef][Medline]
Intensive treatment of women with gestational diabetes lowered risk of perinatal complications for their infants (1% vs. 4%; RR 0.33, 95% CI 0.14 to 0.75) in a randomized clinical trial. Furthermore, three months postpartum, mood and quality of life was superior in intensively treated mothers.
(N Engl J Med (Epub ahead of print June 12, 2005) 10.1056/NEJMoa042973)
Foci of multifocal papillary thyroid cancers arose from distinct cellular clones in at least one-half of ten patients studied—consistent with independent sites of carcinogenesis rather than intraglandular metastases, and providing a rationale for the practice of eradicating residual thyroid tissue in affected patients.
(New Engl J Med (June 8, 2005) 352:2406)[Abstract/Free Full Text]
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Endocrine Practice
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There was a 30% decrease in the incidence of end-stage kidney disease in people with diabetes between 1996 and 2002, according to the CDC, which also reported that between 1994 and 2002 there was a 35% reduction in diabetes-related preventable hospital admissions. (See: http://www.diabetes.org/uedocuments/GoodNewsCDC.pdf)
A synthetic analog of a peptide found in Gila monster saliva (Byetta®, Amylin), similar to human GLP-1, has been approved for use in type 2 diabetes patients taking metformin or sulfonylurea, but not those taking insulin. The drug slows digestion and stimulates insulin release—the latter only when glucose levels are high
(Nat Med (June 2005) 9:1228)
(See: http://www.amylin.com/pipeline/byetta.cfm)
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Endocrine Policy
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The International Committee of Medical Journal Editors updated their policy requiring that all papers submitted to member journals be registered as clinical trials in a publicly accessible database, specifying a minimal 20-item data set describing the study and excluding phase 1 trials that lack a prospectively assigned concurrent control group. (See: http://content.nejm.org/cgi/reprint/352/23/2436.pdf)
"Diabetes Forecast" Magazine changed its policies to advertise food products and include recipes that are modest in calories and very low in saturated fat. (See: http://www.diabetes.org/)
A jury awarded $544,759 to two thyroid cancer patients who had been babies residing near the Hanford Nuclear Weapons Reservation in the 1940s, but denied the claims of three hypothyroid patients. (http://seattletimes.nwsource.com/html/localnews/2002280960_webdownwinders19.html)
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Endocrinologists
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Leonard Wartofsky
has been chosen President-Elect of The Endocrine Society.
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Milestones in Endocrinology
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100 years ago, Bulloch and Sequeira described patients with adrenogenital syndrome.
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In the Journal 50 Years Ago
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The effectiveness of triiodothyronine or thyroxine administered orally in the treatment of myxedema. H. A. Selenkow, S. P. Asper.
J Clin Endocrinol Metab 1955; 15:285
. "The results of this study indicate that triiodothyronine is an effective oral medication in myxedema in doses of 70 to 105 µg daily...".
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Footnotes
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Readers are encouraged to suggest items for Endocrinology and Metabolism News by email (sherman{at}endo-society.org). Submissions will be considered based on their significance and timeliness.
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