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Animal studies have identified endocrine disrupting chemicals as potential, albeit unproven, contributors to human disorders, especially to those with fetal origins. These disorders can be detected early if pediatricians are vigilant. Recent evidence for population-level changes in young men and girls, which involve developmental endocrine alterations, underscores the urgency for action.
Selective estrogen receptor modulators (SERMs) hold the promise of an ideal estrogenic compound. Moderate efficacy for the prevention of osteoporotic vertebral fractures has now been found after 5 years of treatment with the SERM bazedoxifene; however, expectations for one SERM to provide multiple benefits for postmenopausal women might be a pipe dream.
Diabetes mellitus has been linked to brain abnormalities and cognitive decline. A report from the Framingham Offspring Study now demonstrates that, in middle-aged and older adults, the core metabolic indicators of diabetes mellitus correlate with continuously distributed properties of brain and cognition, within a clinically normal range.
A novel study by Del Mastro and colleagues suggests that the occurrence of early menopause as a consequence of chemotherapy can be reduced by triptorelin-induced temporary ovarian suppression during chemotherapy in premenopausal patients with early-stage breast cancer. But does this treatment preserve fertility, and will the benefits of continued menstrual function outweigh the risks?
Gut microbes act as an environmental factor that affects an individual's physiology and metabolism, particularly in the context of obesity and its related metabolic disorders. This Review highlights how gut microbes alter the expression of genes involved in the development of obesity and inflammation and focuses on the potential role of specific nutrients that target the gut microbiota.
Osteoporosis is characterized by a decrease in bone mass and alterations in bone architecture that increase bone fragility and risk of fracture. Therapy with recombinant human PTH analogues increases BMD and bone mass and improves the microarchitecture of the skeleton. This Review summarizes the mechanism of action of PTH and discusses pharmacological data as well as the clinical uses of PTH analogues.
Thyrotoxic periodic paralysis (TPP) is an endocrine channelopathy that is often underdiagnosed. TPP results from the combination of genetic susceptibility, environmental factors and thyrotoxicosis. In this Review, the authors propose an integrated etiopathophysiological model of TPP that is based on molecular findings and knowledge gained from long-term follow-up of patients with TPP.
This Review provides a brief overview of the prevalence, clinical effect and management of endocrine incidentalomas with a focus on data regarding the diagnostic and therapeutic challenges imposed by incidentally discovered adrenal lesions.
Many individuals with prediabetes have been shown to have neuropathy and vice versa. This Review summarizes the current evidence on the association between prediabetes and neuropathy and discusses the assessment of glucose metabolism as part of the diagnostic work-up for neuropathy.
