Volume 6 Issue 2, February 2010

The paradigm that obesity at any age is protective against skeletal failure has been ingrained in clinical practice for several decades. A new study published in the Journal of Bone and Mineral Research challenges the basic framework of that tenet.

Anovulatory infertility is common in polycystic ovary syndrome (PCOS). Clinicians who provide first-line treatment have to decide how best to induce ovulation with the desired outcome of live birth, a decision often complicated by the phenotypic heterogeneity of PCOS. Could a new live birth prediction model of different ovulation induction methods developed from basic clinical parameters help select infertility treatments?

A new study published in the Journal of Clinical Oncology has ascertained the efficacy of selective serotonin-reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors and gabapentin to decrease menopausal hot flashes. Are these nonhormonal treatment options a viable alternative to hormone replacement therapy?

Mortality rates are increased in acromegaly. Previous studies have shown that growth hormone and insulin-like growth factor 1 levels, male gender, age, hypertension, delayed diagnosis and prior pituitary radiotherapy are independent predictors of increased mortality. A new study by Sherlock et al. now adds adrenal insufficiency and hydrocortisone replacement dose to the list of independent predictors of acromegaly-associated mortality.

Should women with gestational diabetes mellitus be treated to minimize both fetal and maternal complications? Although unanswered questions remain about the long-term benefits, the findings of a large, multicenter, randomized controlled trial suggest that treatment of gestational diabetes mellitus decreases perinatal complications.

Adipocytes store energy and regulate themselves depending on the environment. Clinical studies suggest that excess macronutrient intake may induce cellular lipid loading and promote signs of inflammatory stress, which ultimately leads to metabolic dysfunction. This Review discusses how lipid mediators may act on important immune receptors to induce low-grade tissue inflammation, which leads to adipocyte and metabolic dysfunction in obesity.

Raised levels of aldosterone, but also concentrations within the normal range are associated with elevated blood pressure. The authors of this Review assess evidence for the role of aldosterone in the development and maintenance of hypertension, including experimental and clinical studies, and discuss the genetic and environmental mechanisms that underlie its effects.

Diabetic angiopathy is among the most serious consequences of diabetes mellitus owing to its impact on quality of life, morbidity, mortality and burden to health-care systems. This Review discusses data that support a role of dysregulation of components of the complement system and the tumor necrosis factor superfamily in the development of diabetic angiopathy.

Mounting evidence suggests that gastrointestinal surgical procedures, such as gastric bypass, can induce long-term remission of type 2 diabetes mellitus (T2DM) and other metabolic disorders. Here, Rubino and colleagues provide an overview of the use of 'metabolic surgery' for patients with T2DM and discuss the implications for future research. The authors hypothesize that the gastrointestinal tract might have a key role in the pathophysiology of T2DM and obesity.

A thorough understanding of the diagnosis and treatment of familial paraganglioma syndromes is required for optimal therapy and management of patients with mutations of the succinate dehydrogenase complex. In this Case Study, Ayala-Ramirez and colleagues discuss current techniques for the localization of pheochromocytomas, paragangliomas and gastrointestinal stromal tumors and address the controversies of surgical removal of bilateral pheochromocytomas caused by a hereditary syndrome in a patient with Carney-Stratakis syndrome and paraganglioma syndrome type 1.