Volume 7 Issue 12, December 2011

Dose-response studies with patient-specific outcomes rather than surrogate measures of efficacy are needed to determine the benefits of vitamin D supplementation in the elderly. A novel study from Australia now casts doubt on the usefulness of intermittent, high-dose vitamin D supplementation as a strategy to reduce falls and fractures.

Glycemic control for many patients with type 2 diabetes mellitus (T2DM) is elusive, and the adverse effects of treatment, including hypoglycemia and weight gain, are partially culpable. Until recently, glycosuria has been regarded only as a consequence of T2DM, but dapagliflozin employs glycosuria as a mechanism of treatment. Will this paradigm shift gain acceptance?

Primary aldosteronism is a common, but often overlooked, cause of arterial hypertension. Recent guidelines by the Japanese Endocrine Society should improve detection of this surgically curable disorder, but their endorsement of a 'confirmatory' test in patients with a positive aldosterone-to-renin ratio must be viewed with caution.

Health-care professionals must be educated about the existence of obese individuals who are metabolically healthy and normal-weight individuals who are metabolically unhealthy. A better understanding of obesity subgroups could provide new insights into the development of cardiovascular diseases and type 2 diabetes mellitus and help chose adequate treatments.

Diabetes insipidus is a clinical syndrome characterized by the excretion of abnormally large volumes of dilute urine (polyuria) and increased fluid intake (polydipsia). This Review focuses on the clinical presentation, genetic basis and molecular mechanisms of the currently known familial forms of diabetes insipidus.

Estrogens regulate physiological and pathological processes in both women and men. Traditionally, the actions of 17β-estradiol, the predominant and most potent endogenous estrogen, were ascribed to two nuclear estrogen receptors (ERs), ERα and ERβ; however, transmembrane ERs, such as G-protein-coupled ER 1 (GPER), have been implicated in rapid estrogen signaling. This Review provides an overview of estrogen signaling and its receptors, with particular emphasis on GPER. It also highlights the importance of GPER in health and disease, such as cancer, for which GPER is a potential therapeutic target and prognostic indicator.

The anterior pituitary gland secretes hormones that regulate developmental and physiological processes, such as growth, the stress response, and reproduction. This Review summarizes the gene regulatory pathways that control anterior pituitary development, with emphasis on the role of the homeodomain transcription factors in normal pituitary organogenesis and heritable pituitary disease.

Diabetes mellitus is an established risk factor for periodontitis, and periodontitis can adversely affect glycemic control. This Review discusses the complex relationship between these two conditions and the implications of this association for patients and health-care professionals.

This Case Study illustrates some of the potential pitfalls of diagnosis and demonstrates a combination of problems of follow-up biochemical screening in a patient operated for a large pheochromocytoma at increased risk of malignant disease. The difficulty in assessing the presence of disease after initial surgical resection and reaching a diagnosis of malignancy are highlighted.