The Journal of Clinical Endocrinology & Metabolism Vol. 94, No. 7 17a-18a
Copyright © 2009 by The Endocrine Society
Endocrinology & Metabolism News
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Endocrine Discovery
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Among patients’ relatives of patients in the Diabetes Prevention Trial–Type 1 screened for islet cell autoantiobodies, and, when positive, by glucose tolerance tests, 218 individuals were diagnosed with diabetes; 63% of them reported no symptoms suggestive of diabetes and 51% had A1C in the normal range.
(Diabetes Care [May 2009] 32 (5):769)
No association between inhaled steroids and serum glucose was found for subjects without diabetes, but among those with diabetes, steroid use increased serum glucose in a dose-response manner in a retrospective study of subjects with (n=323) and without (n=1375) self-reported diabetes using IS.
(Am J Med [June 2009] 122 (6): 472)
In a meta-analysis of five prospective randomized controlled trials involving 33,040 participants assessing intensive glucose-lowering regimens’ effects on death and cardiovascular outcomes, a 17% reduction was seen in non-fatal myocardial infarctions (odds ratio 0.83, 95% CI 0.75–0.93) and a 15% reduction in coronary heart disease events (0.85, 0.77–0.93), but no significant effect on stroke (0.93, 0.81–1.06) or all-cause mortality (1.02, 0.87–1.19).
(Lancet [May 23, 2008] 373 (9677):1765)
Of 610 women aged 67–93 years followed for a mean of 13.5 years, women with fractures at baseline were at increased mortality risk from kyphosis, independent of age and other risk factors in a prospective study of the effect on kyphosis on mortality,
(Ann Intern Med [May 19, 2009] 150 (10):681)
A basic scoring system considering anthropometry, blood pressure, and pulse information identified adults at high risk for diabetes. Additional data about fasting blood tests better identified those at extreme risk.
(Ann Intern Med [June 2, 2009] 150 (11):741)
Pregnancy Weight Gain Guidelines Urge Healthy BMI Throughout Reproductive Cycle
Since 1990, more women are gaining too much weight during pregnancy, heightening their risk for maternal and fetal complications such as postpartum weight retention, cesarean section delivery, preterm birth, and chance of childhood obesity. To address these concerns, the Institute of Medicine revised its guidelines for gestational weight gain. These recommendations differ from their 1990 guidelines in that they are now based on the World Health Organization’s body mass index categories and include specific ranges for obese women.
From the perspective that the reproductive cycle begins pre-conception and extends for one year after delivery and that maternal weight over this entire period affects both mother and child, the committee advocates conceiving at a normal BMI and gaining within the recommended range for healthy pregnancy.
Nanette Santoro, M.D., Professor/Director of the Division of Reproductive Endocrinology and Infertility at the Albert Einstein College of Medicine, who was affiliated with the review, agreed. "Optimizing weight pre-conception is very important. Also, pregnancy isn’t a license for a woman to eat whatever she wants," she said. "The fetus, amniotic fluid, and placenta total 10–15 pounds—anything over that is what needs to be lost afterward."
To help women achieve optimal gestational weight gain in future, the committee calls for education and information sharing, including collecting maternal weight data on birth certificates.
(National Academies Press [published online May 28, 2009])
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Endocrine Practice
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FDA notified health-care professionals of the risk of serious liver injury, including liver failure and death with propylthiouracil (PTU) use in children and adults, recommending that the drug only be used in children in extraordinary circumstances, while in adults, physicians should "carefully consider" which antithyroid drug to use. (For more information, see: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm164162.htm. Additional information about this topic can be found in a recently published commentary
(J Clin Endocrinol Metab [June 2009] 94 (6):1881), which can be found at http://jcem.endojournals.org/cgi/content/full/94/6/1881)
FDA is requiring an additional black box warning for the testosterone gel products AndroGel®, and Testim® after reports of premature secondary sex characteristic development in young children who were in close contact with product users. Adverse events associated with testosterone gels should be communicated to the FDA’s MedWatch reporting program by telephone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online at http://www.fda.gov/medwatch, or by mail to 5600 Fishers Lane, Rockville, Maryland 20852-9787.
FDA has given approval to Novartis to revise its dosing recommendations for zoledronic acid (Reclast®), indicating that a single infusion prevents postmenopausal osteoporosis for two years, twice the previous length of action for one treatment. (For more information, go to: http://www.novartis.com/newsroom/media-releases/en/2009/1318842.shtml)
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Milestones in Endocrinology
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150 years ago, Frédérik Rilliet reported iodine’s thyrotoxic effects in his paper "Constitutional iodism."
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In the Journal 25 Years Ago
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Comite F, Pescovitz OH, Rieth KG, Dwyer AJ, Hench K, McNemar A, Loriaux DL, Cutler Jr GB. Luteinizing Hormone-Releasing hormone analog treatment of boys with hypothalamic hamartoma and true precocious puberty.
J Clin Endocrinol Metab 1984;59: 888-892.
"Daily administration of LRHa for 6–12 months to six boys with true precocious puberty associated with a hypothalamic hamartoma lowered gonadotropin and testosterone secretion and abolished the gonadotropin response to LRH."
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FIG. 1. "Optimizing weight pre-conception is very important. Also, pregnancy isn’t a license for a woman to eat whatever she wants."
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FIG. 2. E. Chester Ridgway
E. Chester Ridgway, head of the University of Colorado Health Sciences Center’s Division of Endocrinology, Metabolism and Diabetes, received the Robert H. Williams Distinguished Leadership Award of the Endocrine Society.
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FIG. 3. Constantine Stratakis
Constantine Stratakis, Chief of the Unit on Genetics and Endocrinology at NICHD, has received the Ernst Oppenheimer Award of the Endocrine Society for his work elucidating the molecular basis of inherited syndromes, most notably the Carney Complex.
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FIG. 4. Theo J. Visser
Theo J. Visser, Professor of Internal Medicine at Erasmus University, Rotterdam, has received the Edwin B. Astwood Award Lecture.
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FIG. 5. J. Larry Jameson
J. Larry Jameson, Vice President for Medical Affairs and Dean of the Feinberg School of Medicine at Northwestern University, received the Fred Conrad Koch Award of the Endocrine Society.
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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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