The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 10 17a
Copyright © 2007 by The Endocrine Society
Endocrinology & Metabolism News, October 2007
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Endocrine Discovery
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Long-term total mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes, heart disease, and cancer in a retrospective cohort study of 9949 gastric bypass patients and 9628 severely obese control individuals.
(N Engl J Med [Aug. 23, 2007] 357 (8):753)
In a prospective, controlled study involving 4047 obese patients, the 2010 who underwent bariatric surgery had a 29% lower mortality over an average of 10.9 years in comparison to the remainder who received conventional therapy.
(N Engl J Med [Aug. 23, 2007] 357 (8):741)
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Inpatient treatment with basal-bolus glargine insulin plus glulisine insulin regimen resulted in significant improvement in glycemic control compared with sliding scale regular insulin use alone, but produced no difference in hypoglycemic incidences or length of stay in a prospective randomized trial in 130 patients with type 2 diabetes in a non-intensive care unit setting.
(Diabetes Care [Sept. 2007] 30:2181)[CrossRef]
Following acute coronary syndromes or myocardial infarction, mortality in patients with diabetes was higher compared to individuals without diabetes at 30 days (for both non-ST elevation MI, OR 1.8 [95% CI, 1.2–2.6]; and for ST elevation MI, OR 1.4 [95% CI, 1.2–1.6) and 1 year (HR, 1.7 [95% CI 1.3–2.1) and HR 1.2 [95% CI 1.1–1.4) in a pooled analysis of 62,000 patients enrolled in clinical trials of thrombolytic therapy.
(JAMA [Aug. 15, 2007] 298 (7):765)
Discontinuation of long term androgen replacement therapy resulted in sustained reversal of hypogonadism in approximately 10% of patients with normosmic idiopathic hypogonadotropic hypogonadism or Kallmann’s syndrome.
(N Engl J Med [Aug. 30, 2007] 357 (9):863)
In three siblings—two men and one woman—with hypogonadism due to isolated LH deficiency, homozygous mutation of a 5' splice site in LHß that disrupts mRNA splicing leads to abnormal LHß processing and secretion.
(N Engl J Med [Aug. 30, 2007] 357 (9):897)
SNAI1 and SNAI2 are ectopically expressed in thyroid carcinomas, and aberrant expression in mice is associated with papillary carcinoma development.
(Am J Pathol [Sept. 2007] 171 (3):1037)
In two patients with congenital leptin deficiency shown images of food before and after 7 days of leptin replacement therapy, functional MRI studies found that leptin modulated neural activation in striatal regions containing circuitry controlling food intake, diminishing perception of food reward and enhancing satiety signals.
(Science [Sept. 7, 2007] 317 (5843):1355)
Disrupted glucose sensing in glucose-excited pro-opiomelanocortin (POMC) neurons by transgenic expression of a mutant Kir6.2 subunit interfered with the whole-body response to a systemic glucose load, suggesting that glucose sensing by POMC neurons plays a role in physiological control of blood glucose. Furthermore, it was found that POMC neuron glucose sensing was defective in obese mice on a high-fat diet, an effect that involves the mitochondrial uncoupling protein 2, as its genetic deletion prevented obesity-induced loss of glucose sensing.
(Nature [Sept. 13, 2007] 449 (7159):228)
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Endocrine Practice
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The Centers for Medicare and Medicaid Services offered guidance to state Medicaid agencies as they implement tamper-resistant prescription pads, although these will not be reimbursable by CMS and each state is responsible for defining the forms’ specific features. (For more information, go to: http://www.cms.hhs.gov/DeficitReductionAct/Downloads/Tamper.pdf).
Zoledronic acid (Reclast®, Novartis), was approved by the Food and Drug Administration as the first once-a-year treatment for osteoporosis. Although it contains the same active agent as Zometa®, Reclast® is available as a 5 mg dose, whereas Zometa® comes in 4 mg and 8 mg doses.
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Endocrine Policy
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A report commissioned by the American Association of Medical Colleges and prepared by a panel of experts on obesity and obesity education recommends changes in doctors’ future approach to prevention and treatment of overweight and obesity for both their individual patients and their communities including a multidisciplinary approach to obesity study and education, and more programs in basic science, medicine, and population health education. (For more information: Go to http://www.aamc.org/obesityreport).
NIH released a "Policy for Sharing of Data Obtained in NIH Supported or Conducted Genome-Wide Association Studies." The final policy addresses concerns about privacy protections for individuals whose information and specimens are included, lengthens to 12 months the period of exclusive publication rights, and provides support for researchers and institutions that are required to comply with the policy. (For more information, see: http://grants.nih.gov/grants/guide/notice-files/NOT-OD-07-088.html).
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Endocrinologists
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James Melby, a Boston University endocrinologist and expert on the adrenal glands and hypertension, died at age 79 at his summer home in Friendship, Maine.
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Milestones in Endocrinology
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100 years ago, Kocher, Halsted, Evans, Billings, and the Mayo brothers described approaches to surgical treatment of exophthalmic goiter in the Journal of the American Medical Association.
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In the Journal 25 Years Ago
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Improvement of insulin secretion but not insulin resistance after short-term control of plasma glucose in obese type II diabetics. Hidaka H, Nagulesparan, Klimes I, Clark R, Sasaki H, Aronoff SL, Vasquez B, Runenstein AH, Unger RH.
(J Clin Ensocrinol Metab [Feb. 1982] 54:217)
"10 days of control of plasma glucose by insulin improved insulin response to oral glucose but did not change insulin resistance in obese type II diabetics. These results suggest that both the impaired insulin response and the insulin resistance in obese type II diabetics are, in part, secondary to metabolic abnormalities associated with hyperglycemia."
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Footnotes
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Readers are encouraged to suggest items for Endocrinology and Metabolism News by E-mail (sherman{at}endo-society.org). Submissions will be considered based on their significance and timeliness.
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