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Researchers have randomly assigned 811 overweight adults to low-calorie diets with differing percentages of energy derived from protein, carbohydrate, and fat; participants were followed up for 2 years. All groups experienced modest weight loss and improvements in cardiac and diabetes risk factors. Does this finding mean that clinicians can finally advise their patients on the best way to lose weight?
Parathyroidectomy is curative in primary hyperparathyroidism, but elderly patients are often denied this treatment owing to concerns over operative risks and doubts over efficacy of the intervention in improving symptoms. This view is changing, however, as evidence accumulates of the efficacy and safety of the procedure in the aged.
Previous randomized, controlled studies of growth hormone supplementation in the elderly have reported body-composition improvements but no beneficial effect on strength or physical function. The findings of a new study, however, hint at a potential benefit from the treatment for elderly individuals with functional decline.
Response to medical therapy for acromegaly is highly variable, with few predictive factors available to help clinicians make informed treatment choices. Researchers in the UK now suggest that prior radiotherapy might influence an individual's response to secondary therapy with dopamine agonists or somatostatin analogs.
Although previous studies unequivocally demonstrated that type 2 diabetes mellitus (T2DM) has a strong genetic component, the genes that contribute to the risk of this disease were largely unknown until recently, owing to the complexity of genetic and environmental interactions that are involved in T2DM. Genome-wide association studies, which provide global searches throughout the entire genome, have greatly improved our understanding of the genetic background of diabetes mellitus. Here, the authors discuss the currently available findings of diabetes-related genome-wide association studies and examine the utility of the genetic loci identified in these studies as predictors of T2DM.
The role of sex steroids in the regulation of bone metabolism has been extensively studied in women; however, less is known about their skeletal effects in men. On the basis of associations between serum estradiol levels, bone metabolism and fracture risk in adult men and skeletal symptoms in young men with estrogen resistance or aromatase deficiency, the authors suggest a crucial role for estradiol in regulating skeletal growth and health in men.
Noninvasive imaging modalities are increasingly used to study various aspects of diabetes mellitus. The authors of this article focus on the application of MRI, a modality that can provide not only anatomical and functional but also molecular information, for monitoring islet transplantation. Potential causes of islet graft failure, and novel technologies for the simultaneous imaging and delivery of experimental therapies to prevent such failure are also discussed.
Whilst less than 5% of pituitary tumors are familial, identification of familial pituitary tumor syndromes is important owing to the associated pathologies that might occur and the important implications for family members. Advances have been made in our understanding of these syndromes in the past decade and four genes have now been identified as being associated with familial pituitary tumors:MEN1, CDKN1B, PRKAR1A and AIP. This article reviews the current state of knowledge of familial pituitary tumor syndromes.
This case illustrates some of the difficulties in treating anovulatory women with polycystic ovary syndrome, which is the most common cause of anovulatory infertility. Insulin resistance is a contributing factor to the pathogenesis of the syndrome. Assisted conception therapy is an effective treatment for women with polycystic ovary syndrome who are refractory to standard ovulation induction therapies or who have co-existing infertility factors. However, women with polycystic ovaries are particularly sensitive to stimulation with gonadotropins and have an increased risk of developing ovarian hyperstimulation syndrome.
