Review Articles in 2007

As detailed here, the discovery of small, interfering RNA molecules and their naturally occurring counterpart, micro-RNA molecules, has greatly influenced modern research and has also given new insights into endocrine diseases. Therapeutic applications of RNA interference have now reached the stage of clinical trials.

Obesity rates are increasing alarmingly in children and infants, with predictable but devastating consequences for health. This article outlines the causes for these increases and suggests strategies to prevent and treat childhood obesity. These include a systematic approach from pediatricians and input from the family, school and community.

Thankfully, survival rates for cancer sufferers are improving all the time. One crucial issue affecting patients' quality of life is preservation or optimal enhancement of fertility, which can be compromised during treatment. This article outlines the impact of treatment, predictive markers of reproductive function and methods to prevent infertility among women.

Replication of β cells is important in childhood expansion of β-cell mass, and offers a potential therapeutic strategy for diabetes. As discussed here, however, mechanisms of increased β-cell mass in adulthood in humans are not well understood, and the influence of mechanisms such as apoptosis might interfere with therapeutic approaches.

Although its performance-enhancing effects remain unclear, athletes are thought to be doping themselves with recombinant human growth hormone, which is banned by regulatory authorities for this context. This article describes the challenges faced in designing test methods to detect this abuse, and details the assays that are currently in use or development.

Bilateral adrenocortical hyperplasias (BAHs) are one cause of adrenocorticotropin-independent Cushing's syndrome. Until recently BAHs were relatively unknown and thought to be infrequent. This article reviews the molecular genetics of adrenocortical tumor development with an emphasis on BAHs. It also suggests a classification for BAHs that is based on their genetics and histology.

Polycystic ovary syndrome adversely affects the reproductive phenotype of many women. This article describes the characteristic clinical symptoms and discusses the basis for altered reproductive physiology. It also details the ways in which androgens, estrogens, gonadotropins, insulin and obesity might interact to cause and/or perpetuate some of the manifestations of this condition.

Although it affects food intake and energy partitioning, the precise role of the various forms of ghrelin and its receptor(s) in energy balance remains unclear. As described here, its specific effects on glucose homeostasis mean that it is a potential target to prevent and treat obesity and type 2 diabetes.

The features that comprise the metabolic syndrome allow clinicians to identify people at risk of developing diabetes and cardiovascular disease. As outlined in this article, these features can affect the risk to women and men differently. In addition, several modifiers specific to women affect risk factor identification and clinical management.

Thyroid nodules are very common; however, their etiology is largely unknown. In this article the authors suggest mechanisms behind the high rates of thyroid tumors. These include the oxidative nature of thyroid hormone synthesis, which is exacerbated by iodine deficiency; this (along with other conditions) can also affect thyroid cell proliferation.

A range of analogs are being tested for their ability to reproduce or enhance the beneficial effects of thyroid hormone while minimizing its less-desirable actions in particular situations. This review describes the best-studied of these agonists and receptor-antagonists, detailing their effects on cardiac function, lipid metabolism and weight loss.

Recombinant human TSH (rhTSH) is now available for use in patients with thyroid cancer. As discussed in this article, it is used as preparation before radioiodine-mediated thyroid-remnant ablation and to stimulate serum thyroglobulin levels. Using rhTSH avoids many of the unwanted effects caused by withdrawal of levothyroxine therapy.

The success of anti-HIV therapy using antiretroviral drug combinations has been tempered by metabolic effects—especially body-fat distribution, insulin tolerance, dyslipidemia, and bone demineralization. This article details the clinical, biological and therapeutic consequences of altered metabolism resulting from interactions of anti-HIV drugs with HIV and with non-HIV-related parameters.

Microarray technology is well established as a research tool, and now it is increasingly being used in clinical and diagnostic settings. This article describes the principles behind microarrays, and details the current and potential applications in the search for biomarkers for diabetes, endocrine tumors and hormonal modulators of tumors.

Selective estrogen-receptor modulators (SERMs) improve survival in women with breast cancer. There is, however, a need for more-effective SERMs and, most importantly, tissue-targeted alternatives to classical hormone replacement therapy while preventing breast cancer. This article describes how combining a SERM and dehydroepiandrosterone might prevent breast and uterine cancers, while benefiting other tissues affected by the menopause.

Obesity surgery is an effective means of achieving and maintaining weight loss, curing or improving otherwise chronic, serious comorbidities and reducing mortality. This article describes evolving aspects of patient selection and various surgical options; it also details outcomes and many of the neurogastrointestinal mechanisms of surgery affecting appetite regulation.

This article reviews the role of physical activity in producing and maintaining weight loss. The focus is on prospective randomized controlled trials; however, other prospective trials, meta-analyses and large systematic reviews are included. The limitations of the current body of literature are identified and discussed, and future research directions suggested.

Epigenetic mechanisms alter gene expression without changing the nucleotide sequence; nevertheless, they can transmit through generations of cells. This article discusses how the fetal environment might affect the epigenotype of the fetus and how this might affect subsequent development of diseases, such as diabetes, later in life and perhaps in subsequent generations.

Examination of triglyceride metabolism and lipoprotein profiles in different ethnic groups reveals a range of potential risk factors for heart disease, especially when related to conditions such as insulin resistance. Further study should allow greater understanding of the role of triglycerides in the development of, or protection from, heart disease.

This Review details the complex problems that Graves′ disease can cause for both mother and fetus. The authors describe physiological aspects of maternal thyroid function and the effects on fetal thyroid development. They then discuss the diagnostic testing and therapy of Graves′ disease, and review the ramifications of treatment for the fetus.