Table of contents
August 2006 Volume 2 No 8
Viewpoints
How low to target LDL?
414According to the National Cholesterol Education Program, an optional LDL goal of less than 1.81 mmol/l might now be considered for patients at the highest risk of coronary heart disease. This Viewpoint discusses whether these LDL target levels are safe and describes which agents might help achieve this goal.
The need for a standardized definition for cachexia in chronic illness
416There is no agreed definition for cachexia, and this hampers research and treatment. This Viewpoint emphasizes the importance of definitive cut-off limits for weight loss over time, and the need for straightforward diagnostic criteria. The authors suggest cut-off values for cardiac cachexia but acknowledge that the values might differ in other conditions.
Research Highlights
Letrozole improves final height in boys with constitutionally delayed puberty
418No light shed on national differences in leuprolide dosage regimes
418Leksell Gamma Knife® radiotherapy in patients with acromegaly
418Women with diabetes need good hypertensive control during early pregnancy
419Combined immunotherapy reverses type 1 diabetes in mice
419Air pollution linked to rise in childhood type 1 diabetes
420Persistent obesity could be established in children before the age of 11 years
420A common genetic variation near INSIG2 is associated with obesity
421Overdiagnosis is responsible for the increasing incidence of thyroid cancer in the US
421Bariatric surgery outperforms medical therapy for mild or moderate obesity
421Vitamin D and calcium supplementation recommended after gastric bypass surgery
422Poor compliance reduces the efficacy of calcium supplementation
422Normal values for growth hormone should be reduced for obese adults
423Practice Points
Partial tumor debulking enhances the response to somatostatin analogs in acromegaly
424What is the optimal follow-up strategy for patients with papillary thyroid microcarcinoma?
426How effective is rimonabant at promoting and maintaining weight loss in patients with obesity?
428Does teriparatide given in combination with menopausal hormone replacement therapy improve bone mineral density?
430How effective is testosterone replacement therapy in premenopausal women with severe androgen deficiency?
432Reviews
Clinical utility of measurements of insulin-like growth factor 1
436The level of insulin-like growth factor 1 (IGF-I) is influenced by many factors but, as detailed here, IGF-I measurements are useful to screen for growth hormone deficiencies in children and young adults. IGF-I levels are an excellent diagnostic test for acromegaly but are also useful to assess disease severity and the response to treatment.
doi:10.1038/ncpendmet0244 | Full Text | PDF (202K)
Childhood obesity: behavioral aberration or biochemical drive? Reinterpreting the First Law of Thermodynamics
447This Review examines the biochemistry that underlies the behaviors of obesity, in particular the relationship between hyperinsulinemia and leptin resistance. Hyperinsulinemia promotes the behaviors of increased calorie intake, decreased exercise and altered hedonic reward responses to food that are associated with the current obesity epidemic.
doi:10.1038/ncpendmet0220 | Full Text | PDF (355K)
Therapy insight: use of melanocortin antagonists in the treatment of cachexia in chronic disease
459Many chronic diseases produce a condition called cachexia, which involves anorexia, decreased lean body mass and increased energy expenditure, worsening the prognosis for the underlying disease. This article describes a promising new approach to treating cachexia, targeting a key appetite-regulating center in the hypothalamus called the melanocortin system.
doi:10.1038/ncpendmet0221 | Full Text | PDF (212K)
Case Study
Recurrent hyperinsulinemic hypoglycemia caused by an insulin-secreting insulinoma
467doi:10.1038/ncpendmet0263 | Full Text | PDF (116K)
