Bone: Vitamin D deficiency implicated in bone mineralization defects | PDF (108 KB)
p583 | doi:10.1038/nrendo.2009.183
Table of contents
November 2009 Vol 5 No 11
Research Highlights
Nitroglycerin and bone loss | PDF (48 KB)
p584 | doi:10.1038/nrendo.2009.184
Diabetes: Antipsychotic drugs and hyperglycemia risk in diabetes | PDF (102 KB)
p584 | doi:10.1038/nrendo.2009.185
Cancer: Potential modulators of ovarian cancer risk assessed | PDF (53 KB)
p585 | doi:10.1038/nrendo.2009.186
In brief
Bone | Cancer | Bone | PDF (45 KB)
p585 | doi:10.1038/nrendo.2009.192
Pituitary gland: Prevalence of pituitary adenomas in a geographically well-defined population | PDF (53 KB)
p586 | doi:10.1038/nrendo.2009.190
Bone: Depression—a novel risk factor for low BMD | PDF (73 KB)
p586 | doi:10.1038/nrendo.2009.191
Diagnosis: Assay variability of biochemical markers of bone turnover | PDF (49 KB)
p587 | doi:10.1038/nrendo.2009.167
Obesity: Overweight as a risk factor for dementia | PDF (51 KB)
p587 | doi:10.1038/nrendo.2009.168
Apolipoprotein B in type 1 diabetes | PDF (48 KB)
p587 | doi:10.1038/nrendo.2009.169
Diabetes: Glucose levels and adverse pregnancy outcomes | PDF (93 KB)
p588 | doi:10.1038/nrendo.2009.163
Effects on child nutrition patterns | PDF (46 KB)
p588 | doi:10.1038/nrendo.2009.170
News and Views
Thyroid gland: Pregnancy—a risk factor for thyroid surgery complications
Daniel Ruan & Jacob Moalem
p589 | doi:10.1038/nrendo.2009.211
Pregnancy can exacerbate endocrinopathies and obscure their diagnosis in patients with parathyroid or thyroid disease. A large, population-based study published in Archives of Surgery demonstrates that pregnant women carry an increased risk of surgical complications, longer hospitalization and higher costs from parathyroid and thyroid surgery than nonpregnant patients.
Adrenal gland: Hypertension during remission of childhood Cushing syndrome
John Newell-Price
p591 | doi:10.1038/nrendo.2009.200
Long-term adverse consequences of excess circulating glucocorticoids are gaining increasing recognition. The results of a study in children with endogenous Cushing syndrome now show that hypertension can persist even in remission, and raise important issues for the long-term management of these children's health, and potentially for the many children treated with glucocorticoids.
Thyroid gland: Antithyroid therapy—best choice of drug and dose
Jayne A. Franklyn
p592 | doi:10.1038/nrendo.2009.201
Agranulocytosis is the most severe adverse effect of antithyroid drug therapy. The findings of a novel study from Japan suggest that this complication occurs more frequently if higher rather than lower starting doses of the thionamide drug methimazole are prescribed. Has the time come to reassess current therapy regimens?
Screening: Correlation of genotype and phenotype in paraganglioma
Bora E. Baysal
p594 | doi:10.1038/nrendo.2009.202
Screening of patients with paraganglioma revealed a high prevalence of germ line mutations in genes encoding subunits of the succinate dehydrogenase complex, according to a new study. Should gene testing become a routine part of the clinical management of patients with paraganglioma?
Reviews
Management of children with acute malnutrition in resource-poor settings
Kenneth H. Brown, Daniele H. Nyirandutiye & Svenja Jungjohann
p597 | doi:10.1038/nrendo.2009.194
This review discusses newly recommended screening approaches for childhood acute malnutrition in low-income settings, using mid-upper arm circumference or weight for height Z-score and inspection for presence of bipedal edema. A treatment algorithm is provided to guide management of children with severe acute malnutrition and systemic complications who require inpatient therapy and for those with uncomplicated severe or moderate acute malnutrition who can be treated in the community using recently developed ready-to-use-therapeutic foods or other appropriately designed food blends.
Nutritional programming of the metabolic syndrome
Michael E. Symonds, Sylvain P. Sebert, Melanie A. Hyatt & Helen Budge
p604 | doi:10.1038/nrendo.2009.195
Early foundations of the metabolic syndrome may be laid as a consequence of changes in dietary supply to the rapidly growing fetus and/or postnatal offspring. This review highlights fetal developmental plasticity in cellular homeostasis that may manifest in adult life as the metabolic syndrome particularly if followed by a period of accelerated postnatal growth.
The FGF23–Klotho axis: endocrine regulation of phosphate homeostasis
M. Shawkat Razzaque
p611 | doi:10.1038/nrendo.2009.196
Regulation of systemic phosphate homeostasis is strictly controlled by a limited number of factors, including FGF23 (a bone-derived protein) and Klotho (a membrane-bound protein). Dysregulation of FGF23 and Klotho is associated with altered phosphate turnover in several acquired and genetic human diseases. The endocrine effects of the FGF23–Klotho axis in normal physiology and disease are described by the author of this Review.
Estrogen therapy: is time of initiation critical for neuroprotection?
Barbara B. Sherwin
p620 | doi:10.1038/nrendo.2009.193
Estrogen therapy can reduce cognitive decline in aging women. However, the beneficial effects of estrogen on cognition are apparent only when treatment is initiated around the time of menopause; the same effect is not detected when estrogen therapy is started years later. The 'critical period' hypothesis attempts to explain this discrepancy. Here, Barbara Sherwin reviews studies in which the timing of estrogen therapy was provided and asks whether their findings support the critical period hypothesis.
Case Study
Diagnosis of insulinoma in a patient with hypoglycemia without obvious hyperinsulinemia
Catarina Coelho, Maralyn R. Druce & Ashley B. Grossman
p628 | doi:10.1038/nrendo.2009.198
Initial diagnosis of insulinoma requires demonstration of inappropriately elevated insulin levels and concurrent hypoglycemia in the absence of administration of exogenous insulin or sulphonylureas. This article presents the case of a patient with insulinoma, who presented with hypoglycemia without coinciding evident hyperinsulinemia according to current guidelines. The article details current diagnostic criteria and highlights the role of clinical judgment in the investigation and management of cases, which do not conform to an expected pattern.
Perspectives
Opinion
CB1 antagonists for obesity—what lessons have we learned from rimonabant?
Vincenzo Di Marzo & Jean-Pierre Després
p633 | doi:10.1038/nrendo.2009.197
The development of anti-obesity drugs has not been straightforward. With very few drugs on the market, and bad publicity related to adverse events, obesity remains a major challenge for the pharmaceutical industry. In light of past experience with endocannabinoid-system antagonists, such as rimonabant, the authors of this Perspectives article propose that a major paradigm shift in clinical practice might be necessary to justify the use of pharmacotherapy for obesity.
