Author Interviews, Depression, JAMA, Testosterone / 16.11.2018

MedicalResearch.com Interview with: Dr. Andreas Walther PhD Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland Task Force on Men’s Mental Health of the World Federation of the Societies of Biological Psychiatry MedicalResearch.com: What is the background for this study? Response: The study situation with regard to endogenous testosterone level and depressive symptoms in men is currently very mixed. There are studies that show no association, but other studies show that low testosterone levels are associated with increased depressive symptoms. That is why several studies have tried to administer testosterone in men to treat depressive symptomatology among other conditions (e.g. erectile dysfunction, cognitive decline). However, no clear conclusions could be drawn from the studies to date, as some studies reported positive results, while others did not show any effects. Likewise, some studies showed better results in certain subgroups of men such as dysthymic men, treatment resistant, men with low testosterone, which raised the question of relevant moderators. (more…)
Author Interviews, Biomarkers, Endocrinology, Prostate Cancer / 14.11.2018

MedicalResearch.com Interview with: Vincenza Conteduca, MD, PhD Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Srl - IRCCS Meldola , Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: In our previous publications, we showed that the study of plasma cell-free DNA holds promise for improving treatment choice in metastatic castration-resistant prostate cancer (mCRPC). Specifically, we demonstrated that the detection in plasma of aberrations (copy number alterations and/or point somatic mutations) of androgen receptor (AR), using an easy and robust multiplex droplet digital PCR method, predicted an adverse outcome in mCRPC patients treated with second-generation AR-directed therapies (abiraterone or enzalutamide) in both settings: chemotherapy-naïve and post-docetaxel. This current multi-institution work builds on our previous discoveries. We investigated the association of androgen receptor status and survival in men treated with docetaxel. Moreover, we performed an exploratory analysis in patients treated with docetaxel or AR-directed therapies as first-line therapy. Interestingly, we observed that plasma AR-gained patients do not have a worse outcome compared to AR-normal patients when treated with docetaxel as first-line therapy. This introduces the opportunity to use plasma to select for docetaxel in preference to androgen receptor-directed therapies in AR gained mCRPC patients. (more…)
Author Interviews, Biomarkers, Endocrinology, JCEM, OBGYNE, Yale / 25.10.2018

MedicalResearch.com Interview with: Valerie A. Flores, MD Clinical Instructor Division of Reproductive Endocrinology & Infertility Department of Obstetrics, Gynecology & Reproductive Sciences Yale School of Medicine - Yale New Haven Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endometriosis is a debilitating gynecologic disease that affects 1 in 10 reproductive-aged women, causing pain and infertility.  It is a hormonally dependent disorder— estrogens promote growth of endometriosis, while progesterone inhibits estrogen-dependent proliferation. Although progestin-based therapies (including combined oral contraceptives) are first-line therapy in the management of endometriosis-associated pain, response to progestins is variable and currently unpredictable. (more…)
Author Interviews, Endocrinology, OBGYNE, Smoking / 24.10.2018

MedicalResearch.com Interview with: Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Several studies have indicated a secular trend towards earlier puberty. This is a potential concern as early puberty has been linked to an increased risk of a number of diseases, such as obesity, diabetes, cardiovascular diseases and certain types of cancer. For this reason, our research team are interested in identifying potential modifiable causes of early puberty. Smoking during pregnancy may be such a modifiable cause of early puberty in the children. Former studies have already linked smoking during pregnancy to earlier age at the daughters’ first menstrual period, a relatively late marker of pubertal development, but other markers of puberty are less studied, especially in the sons. We studied 15,819 sons and daughters. The mothers gave detailed information on smoking during their pregnancies, and the children gave information on a number of pubertal milestones half-yearly from the age of 11 years. The milestones for the sons were age at voice break, first ejaculation of semen, pubic hair and testicular growth, armpit hair growth and onset of acne. For the daughters the milestones were age at their first menstrual period, pubic hair growth, breast development, armpit hair growth and onset of acne. Our results suggested that the more cigarettes the mother smoked during her pregnancy the earlier her children, both sons and daughters, went through puberty. If the mother smoked more than ten cigarettes a day during pregnancy, the children appeared to go through puberty, on average, three to six months earlier than the children of non-smoking mothers. (more…)
Author Interviews, Endocrinology, Fertility, OBGYNE / 05.10.2018

MedicalResearch.com Interview with: Dr. Ernest Loumaye, MD, PhD Co-Founder and CEO ObsEva SA   MedicalResearch.com: What is the background for this announcement? How does Nolasiban work to decrease contractions and improve uterine blood flow? Response: The WHO has recognized infertility as a global health issue, and many couples undergo IVF treatment: there are more than 700,000 annual IVF treatment cycles in Europe and more than 200,000 in the U.S. However, more than 50% of IVF procedures do not result in pregnancy, and failure has tremendous emotional and financial costs to patients.  ObsEva is dedicated to improving fertility outcomes in IVF while also supporting the use of single embryo transfer to minimize multiple births that are associated with significant health risks to mother and baby, as well as significant health costs from premature delivery. Nolasiban works by blocking the hormone oxytocin, which is known to induce uterine contractions.  Nolasiban reduces uterine contractions and could improve uterine blood flow, both effects being favourable for the embryo to properly implant. (more…)
Author Interviews, Endocrinology, JAMA, Thyroid Disease / 02.10.2018

MedicalResearch.com Interview with: thyroid-gland-wikipediaDr. med. Martin Feller, MSc Epidemiology (LSHTM) FMH Allgemeine Innere Medizin & Prävention und Gesundheitswesen Scientific Research Coordinator INSELSPITAL, Universitätsspital Bern Universitätsklinik und Poliklinik für Allgemeine Innere Medizin (RodondiResearch) MedicalResearch.com: What is the background for this study? What are the main findings? Response: SUBCLINICAL HYPOTHYROIDISM IS VERY COMMON, WITH AN ESTIMATED 13 MILLION AMERICANS AFFECTED. SUBCLINICAL HYPOTHYROIDISM IS OFTEN TREATED WITH LEVOTHYROXINE, PARTICULARLY WHEN IT CO-OCCURS WITH SYMPTOMS POTENTIALLY ATTRIBUTABLE TO HYPOTHYROIDISM SUCH AS TIREDNESS, CONSTIPATION, AND UNEXPLAINED WEIGHT GAIN. THIS PRACTICE MAY CONTRIBUTE TO LEVOTHYROXINE BEING THE MOST PRESCRIBED DRUG FROM 2014 ONWARDS IN THE US. HOWEVER, IN OUR META-ANALYSIS OF 21 RANDOMIZED CLINICAL TRIALS, WE OBSERVED NO BENEFIT OF LEVOTHYROXINE THERAPY (COMPARED TO PLACEBO) REGARDING GENERAL QUALITY OF LIFE, THYROID-RELATED SYMPTOMS, DEPPRESSIVE SYMPTOMS, FATIGUE, COGNITIVE FUNCTION, BLOOD PRESSURE OR BODY-MASS INDEX.  (more…)
Author Interviews, Endocrinology, Pediatrics, Race/Ethnic Diversity / 23.09.2018

MedicalResearch.com Interview with: Julie Flom, MD MPH Clinical Fellow Division of Allergy & Immunology Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study?   Response: Women who are minorities and of lower socioeconomic have particularly high rates of exposure to chronic ongoing adversity such as poverty as well as traumatic stressors in their lifetime and are also more likely to have low birthweight infants.  Not all women exposed to chronic adversity or trauma transfer this risk to the next generation – it is primarily when the trauma results in changes in her bodies’ ability to handle ongoing stress that the developing child can be impacted. Our group undertook a study to investigate whether women with increased exposure to traumatic stressors over her lifetime were at higher risk of having low birthweight infants and also whether effects of trauma would only be evident among women who produced higher levels of cortisol, the major stress response hormone, while pregnant. (more…)
Author Interviews, Endocrinology, JAMA, Prostate Cancer, UCLA / 22.09.2018

MedicalResearch.com Interview with: Amar U. Kishan, MD Assistant Professor Department of Radiation Oncology University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Three large randomized trials demonstrated an overall survival (OS) benefit when androgen deprivation therapy (ADT) is combined with radiotherapy (RT) for high-risk prostate cancer (PCa). The duration of ADT in these seminal studies ranged from six months to lifelong. Because ADT has multiple attendant adverse effects--including bone loss, altered metabolism, diminished muscle mass, gynecomastia, hot flashes, and possibly increased cardiovascular events--shortening the duration of ADT without compromising oncologic effectiveness has been an area of active study. Five trials have compared various durations of ADT, reaching conflicting conclusions with respect to overall survival outcomes, with some suggesting an improvement with longer durations of ADT and others failing to show a uniform survival benefit. Most of these trials have amalgamated Gleason grade group 4 (Gleason score 8) PCa with Gleason grade group (GG) 5 (Gleason score 9-10) PCa. Emerging data indicate that GS 9-10 PCa constitutes a distinct subset of high-risk PCa with inferior outcomes and earlier progression than GS 8 disease. With the knowledge that GS 9-10 PCas constitute a distinct, more aggressive form of PCa, one might hypothesize that longer durations of ADT may be more advantageous in both augmenting local control and controlling potential micrometastatic disease. Alternatively, as GS 9-10 lesions by definition contain highly de-differentiated Gleason pattern 5 disease foci and may proceed to a castrate-resistant state more rapidly, one may also hypothesize that GS 9-10 lesions are less responsive to ADT, and longer durations may be counter-productive. In order to identify differences in the impact of ADT duration on clinical outcomes of patients with GG 4 and GG 5 PCa, we performed an individual patient-level meta-analysis of six randomized trials. Our working hypothesis was that longer durations of ADT would offer significant survival benefits in both groups. (more…)
Author Interviews, Endocrinology, Environmental Risks, JAMA, Pediatrics, Thyroid Disease / 17.09.2018

MedicalResearch.com Interview with: Carrie Breton ScD Associate Professor and Director of the MADRES Center Division of Environmental Health Los Angeles, CA 90032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: I am interested in how the environment can influence our very early development, starting in the womb. I have studied the health effects of air pollutants on children for several years and wanted to focus now on the earliest windows of susceptibility.  Thyroid hormones play a critical role in fetal growth and development. We knew we could get information on newborn thyroid levels from the California Department of Public Health’s newborn screening program therefore look at this question in our study population. We found that exposure to high levels of PM2.5 and PM10 throughout most of pregnancy affected TT4 levels in newborns. (more…)
Author Interviews, Endocrinology, Kaiser Permanente, Menopause, OBGYNE, Pediatrics, Pediatrics, Vaccine Studies / 30.08.2018

MedicalResearch.com Interview with: Allison L. Naleway, PhD Senior Investigator Associate Director, Science Programs Center for Health Research Kaiser Permanente MedicalResearch.com: What is the background for this study? Response: Reports of premature menopause after human papillomavirus (HPV) vaccination have received a lot of media attention, including on social media, but these reports were based on a small number of isolated cases. Large studies have demonstrated the safety of HPV vaccination, but parental safety concerns—including potential impact on future fertility—are often cited as one reason for lower HPV coverage. Rates of HPV vaccination have lagged behind coverage rates for other recommended adolescent vaccinations, such as tetanus-diphtheria-acellular pertussis and meningococcal conjugate. (Based on national coverage estimates from 2016, 65% of 13–17 year-old females received at least one HPV vaccination and only 49.5% were up to date with the series, compared to about 88% of adolescents who received Tdap.) We conducted a study of nearly 200,000 young women to determine whether there was any elevated risk of primary ovarian insufficiency (POI) after HPV or other recommended vaccinations.  (more…)
Author Interviews, Endocrinology, NEJM / 01.08.2018

MedicalResearch.com Interview with: Prof. Dr. Mirjam Christ-Crain Professor of endocrinology, diabetes and metabolism Heads the Department of Clinical Research University and University Hospital of Basel   MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Diabetes Insipidus? Response: Drinking more than three litres per day with the equivalent increase in urination is regarded as too much. This drinking by the liter – known as “polyuria polydipsia syndrome" – usually develops over time through habit, or can be a side effect of a mental illness. In rare cases, however, it may be caused by diabetes insipidus. This is when the pituitary gland lacks the hormone vasopressin, which regulates the water and salt content in our body. Patients have a decreased ability to concentrate the urine, therefore lose a lot of fluid and have to increase their fluid intake accordingly to prevent dehydration (= Diabetes insipidus). The distinction between what is considered a "harmless" primary polydipsia and a diabetes insipidus is crucial, as their therapy is fundamentally different. Diabetes insipidus must be treated with the hormone vasopressin, while patients with primary polydipsia require behavioural therapy to reduce their habitual drinking. A wrong therapy can have life-threatening consequences as treatment with vasopressin without indication can lead to water intoxication. (more…)
Author Interviews, Cancer Research, Testosterone / 19.07.2018

MedicalResearch.com Interview with: Traver Wright, Ph.D. Research Assistant Professor Department of Health and Kinesiology Texas A&M University College Station, TX MedicalResearch.com: What is the background for this study?   Response: Many cancer patients suffer from a loss of body mass known as cachexia which results in not only a loss of fat, but a debilitating loss of muscle mass and function. This cachexia negatively impacts patient mobility and quality of life, and can also reduce their eligibility to undergo treatments such as radiation and chemotherapy.  Despite the profound negative consequences of cachexia, there are no established therapies to directly address this debilitating loss of body mass during treatment. In this National Cancer Institute funded double-blind, placebo-controlled study we examined the effectiveness of 7 weeks of treatment with the muscle-building hormone testosterone to preserve the body condition of men and women with cervical or head and neck cancer.  Twenty-one patients received weekly injections of either placebo or testosterone.  Over the 7 weeks of treatment, patients were monitored for changes in body composition, activity level, physical ability, and questionnaires regarding quality of life and well-being. (more…)
Annals Internal Medicine, Author Interviews, Emory, Endocrinology, Heart Disease, Sexual Health, Thromboembolism / 10.07.2018

MedicalResearch.com Interview with: Michael Goodman, MD, MPH Professor of Epidemiology Director, MD/MPH program Emory University School of Public Health Atlanta, GA  30322 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a concern that hormone therapy may be associated with higher risk of certain cardiovascular problems such as heart attacks, stroke and formation of blood clots (“venous thromboembolism”). To study this concern we examined data on 4,960 transgender and gender non-conforming people enrolled in Kaiser Permanente health systems in Georgia, Northern California, and Southern California. They were matched to 48,686 cisgender men and 48,775 cisgender women.  Below are the main findings
  • Rates of venous thromboembolism in all transwomen were approximately twice as high as the rates among cisgender men or cisgender women. The data for stroke and myocardial infarction demonstrated little difference between transwomen and cisgender men, but 80% to 90% higher rates among transwomen compared to cisgender women.
  • When the analyses focused specifically on transwomen who started therapy with female hormone estrogen at Kaiser Permanente, the incidence of both venous thromboembolism and stroke was more clearly elevated relative to either reference group.  There was evidence that incidence of both of these conditions among transwomen was particularly increased two to six years after estrogen initiation. By contrast, the association between estrogen therapy and myocardial infarction was less evident due to relatively few observed events.
  • Transmen did not appear to have significantly higher rates of venous thromboembolism, ischemic stroke, or myocardial infarction than their non-transgender counterparts, but this group was rather young and included a relatively small proportion of participants who initiated their hormone therapy during the study.
(more…)
Author Interviews, Cancer Research, Endocrinology, JAMA, Pediatrics / 02.07.2018

MedicalResearch.com Interview with: “Cancer awareness” by Susan Roberts is licensed under CC BY 2.0Mette Vestergaard Jensen, MD Danish Cancer Society Research Center MedicalResearch.com: What is the background for this study? Response: Cancer survival rates have improved and it is necessary to explore the long-term consequences of cancer treatment. Adolescents and young adults with cancer are at risk for several therapy-related late effects; however, these have not been studied extensively. We investigatet the lifetime risks of endocrine late effects of cancer and cancer treatment in adolescent and young adult cancer s (more…)
Alcohol, Author Interviews, Endocrinology, Genetic Research / 28.06.2018

MedicalResearch.com Interview with: Toni Pak, Ph.D. Professor and Department Chair Department of Cell and Molecular Physiology Loyola University Chicago Maywood, Ill  MedicalResearch.com: What is the background for this study? Response: We have known for many years that drinking alcohol during pregnancy can lead to developmental delays and birth defects in offspring. However, our data demonstrate that drinking large quantities of alcohol in a “binge” fashion before pregnancy can also impact future offspring and importantly, this is true for drinking behaviors of both parents, not just the mother. Our previous data support the idea that alcohol is affecting the parental sperm and eggs to induce these modifications in the offspring, but this most recent work shows the extent of those effects on social behavior, pubertal maturation, and stress hormones as the offspring grow to adulthood. This means that the risky behaviors of young people, such as the extremely popular practice of binge drinking, have potentially far-reaching consequences for generations to come. (more…)
Author Interviews, Endocrinology, Social Issues, University of Pennsylvania / 01.06.2018

MedicalResearch.com Interview with: “Monkeys” by Dmitry Baranovskiy is licensed under CC BY 2.0Yaoguang Jiang PhD Postdoctoral Researcher PLATT Lab University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Oxytocin (OT) and arginine vasopressin (AVP) are important neuropeptides known to influence social behaviors in a wide array of mammals. In humans, OT is widely referred to as the ‘prosocial’ hormone and is thought to promote social functions in neurotypical individuals as well as those diagnosed with autism spectrum disorder (ASD). Currently, dozens of ongoing clinical trials in the US are trying to evaluate the therapeutic potential of these neuropeptides in remedying social deficits associated with disorders such as ASD. Yet there are significant gaps in our knowledge especially regarding the neurobiological basis of OT and AVP function. Most importantly, we are unclear which brain areas and pathways these neuropeptides act on to influence social behavior. Additionally, due to strong similarity in molecular structure, OT can bind to AVP receptors with high affinity and vice versa, making it difficult to rule out the possibility that, for example, the behavioral effect of exogenous oxytocin is mediated through the AVP system. Both of these questions have been thoroughly investigated in rodents, but unfortunately the same thing cannot be said for humans. Our study aims to bridge the gap between rodent and human literature on neuropeptide function by studying rhesus macaque monkeys. These monkeys resemble human beings not only in their social behaviors, but also in the neural network that is supporting those behaviors. In this study we show that treating one male macaque monkey intranasally with aerosolized OT relaxes his spontaneous social interactions with another monkey. Oxytocin reduces differences in social behavior between dominant and subordinate monkeys, thereby flattening the status hierarchy.Oxytocin also increases behavioral synchrony within a pair, perhaps through increased attention and improved communication. Intranasal delivery of aerosolized AVP reproduces the effects of OT with greater efficacy. Remarkably, all behavioral effects are replicated when either OT or AVP is injected focally into the anterior cingulate gyrus (ACCg), a brain area linked to empathy, vicarious reward, and other-regarding behavior. ACCg lacks post-synaptic OT receptors but is rich in post-synaptic AVP receptors, suggesting exogenous OT may shape social behavior, in part, via nonspecific binding, particularly when available at supra-physiological concentrations.  (more…)
Author Interviews, Endocrinology, Sleep Disorders, Testosterone, Urology / 23.05.2018

MedicalResearch.com Interview with: Kristen L. Knutson, PhD Associate Professor Center for Circadian and Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine Chicago, IL  60611​Premal Patel, MD, PGY-5 Urology University of Manitoba MedicalResearch.com: What is the background for this study? What are the main findings? What should readers take away from your report? Response: Within the literature there has only been small experimental studies which looked at impaired sleep and testosterone. To our knowledge, there has been no study that has evaluated sleep and testosterone using a population dataset. We utilized the National Health and Nutrition Examination Survey to assess the association of sleep with serum testosterone. NHANES examines a nationally representative sample of about ~5000 persons each year. After performing a multivariate linear regression of numerous variables within the NHANES database (age, marital status, prior co-morbidities, number of hours of sleep, etc…) we found that a reduction in the number of hours slept, increasing body mass index and increasing age were associated with lower testosterone levels. Given that this is a cross-sectional analysis, we are unable to provide causality of this relationship but we do feel it is important to counsel patients with low testosterone about the importance of living a healthy lifestyle which includes a well-balanced diet, exercise and sufficient sleep. (more…)
Author Interviews, Depression, Endocrinology, JAMA, Mental Health Research, Thyroid Disease / 14.05.2018

MedicalResearch.com Interview with: Thyroid gland Wikipedia imageTeja Grömer PD Dr. med. Habil Facharzt für Psychiatrie und Psychotherapie Lehrbefugter der Universität Erlangen-Nürnberg im Fach Psychiatrie Bamberg  MedicalResearch.com: What is the background for this study? 1) I had seen hundreds of clinical cases with combined depression and anxiety and noted end of 2015 that most (far more than 50%) from the subjective clinical impression were associated with autoimmune thyroiditis (AIT) 2) Autoimmune thyroiditis on the mental side leads to specific symptoms, exhaustion, tachycardia, restlessness. 3) I thus decided to do a systematic review and meta-analysis.  (more…)
Author Interviews, Endocrinology / 04.05.2018

MedicalResearch.com Interview with: Marcus M. Seldin PhD (Post-doc researcher) and Professor Aldons J. Lusis, PhD Department of Medicine, Department of Human Genetics Department of Microbiology, Immunology and Molecular Genetics University of California, Los Angeles, CA,  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are thousands of proteins which circulate in the blood and relay signals between tissues, however many of their functions remain difficult to dissect.  We used a mouse population, termed the Hybrid Mouse Diversity Panel (HMDP) to ask if we can identify new factors which communicate between tissues.  Taking this approach, we uncover several proteins which relay signals between tissues.  These include Lipocalin-5, an adipose-expressed protein which can promote skeletal muscle respiration and liver-derived Notum which enhances thermogenesis in fat tissue.  The approach we developed can also be broadly applied to many mouse and human datasets.  As proof of this, we show that cross-tissue predictions are remarkably conserved between mice and humans (more…)
Author Interviews, Endocrinology, Mental Health Research, OBGYNE / 12.04.2018

MedicalResearch.com Interview with: Aled Rees, MD, PhD Neuroscience and Mental Health Research Institute Cardiff University School of Medicine, Health Park Cardiff United Kingdom MedicalResearch.com: What is the background for this study?   Response: PCOS is a common condition, affecting 5-10% of women globally, in which elevated male hormone levels can cause a range of distressing and life-limiting symptoms, including reduced fertility, irregular periods, excessive facial and body hair, and acne. Previous studies have suggested a link between PCOS and poor mental health in women but the studies were small and did not adequately take other factors that can affect mental health into consideration. In addition, high levels of testosterone during pregnancy have been reported to increase the risk of neurodevelopmental disorders, such as ADHD and autism, in children. (more…)
Author Interviews, Hormone Therapy, Menopause / 25.03.2018

MedicalResearch.com Interview with: Jerilynn C. Prior, MD Professor in the Department of Medicine Division of Endocrinology and Metabolism University of British Columbia in Vancouver Dr. Prior has written the second edition of the award-winning book, Estrogen’s Storm Season—Stories of Perimenopause this year as an ebook on Google Play. MedicalResearch.com: What is the background for this study? Response: There is an urgent need for an effective therapy for perimenopausal hot flushes/flashes and night sweats (vasomotor symptoms, VMS). Although often considered “estrogen deficiency symptoms” VMS are common and very problematic for women in the menopause transition and who have not yet been one year without flow. About 23% of North American women are now in the perimenopausal age range. Surprisingly VMS are more common in perimenopause than in menopause; 9% of perimenopausal women have severe VMS as classified by the FDA, meaning more than 50 VMS per week of moderate to intense severity. The commonly used therapies for VMS in midlife women have not been proven more effective than placebo! That includes combined hormonal contraceptives (CHC) and menopausal-type hormone therapy (MHT) as well as the SSRI/SNRI anti-depressants and gabapentin.  (more…)
Author Interviews, Thyroid Disease / 22.03.2018

MedicalResearch.com Interview with: Begoña Ruiz Núñez PhD (c) Laboratory Medicine UMC Groningen Co-directora de Healthy Institute President of the Asociación Española de Psico-Neuro-Inmunologí MedicalResearch.com: What is the background for this study? Response: The diagnosis of Chronic Fatigue Syndrome (​CFS)​ is based on the Fukuda criteria, i.e. symptoms, disability, and exclusion of explanatory illnesses, and not by means of physical signs or abnormalities in laboratory test results​. CFS has been described as a ´allostatic overload condition´, where the physiological mechanisms employed to deal with stress contribute to the perpetuation of the disorder. Chronic Fatigue Syndrome patients are 1.9 times more likely to have a high allostatic load index than healthy controls. Thyroid allostasis-adaptive responses, presenting as ​non-thyroidal-illness syndrome, have been found in many conditions, ranging from critical illness, uremia and starvation to tumor​s​. Taken together, it is possible that, despite TSH and T4 levels within reference ranges, Chronic Fatigue Syndrome symptoms may be attributable in part to allostatic responses, i.e. lower thyroid hormone activity, secondary to chronic (low-grade) inflammation caused by e.g. a compromised gut microbiome and gut wall integrity. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, OBGYNE, Weight Research / 20.03.2018

MedicalResearch.com Interview with: Madhusmita Misra, MD, MPH Division Chief, Pediatric Endocrinology Fritz Bradley Talbot and Nathan Bill Talbot Professor of Pediatrics, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Disordered eating behavior is common in conditions of functional hypothalamic amenorrhea, such as anorexia nervosa and exercise-induced amenorrhea, which are also associated with anxiety and depression. In hypoestrogenic rodents, estrogen replacement reduces anxiety-related behavior. Similarly, physiologic estrogen replacement in adolescents with anorexia nervosa reduces anxiety and prevents the increased body dissatisfaction observed with increasing weight. However, the impact of estrogen administration on disordered eating behavior and psychopathology in normal-weight young women with exercise-induced amenorrhea is unknown. Adolescent and young adult normal-weight athletes 14-25 years old with irregular periods were randomized to receive (i) physiologic estrogen replacement using a transdermal patch with cyclic progesterone, or (ii) an oral estrogen-progesterone containing pill (an oral contraceptive pill), or (iii) no estrogen for 12-months. The Eating Disorder Inventory-2 (EDI-2) and Three-Factor Eating Questionnaire (TFEQ) were administered ag the beginning and the end of the study to assess disordered eating behavior and psychopathology. We found that the group that did not receive estrogen had a worsening of disordered eating behavior and psychopathology over the 12-months duration of the study, but this was not observed in the group that received estrogen replacement. Further, body dissatisfaction scores improved over 12-months in the groups receiving estrogen replacement, with the transdermal estrogen group showing the strongest effect. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Environmental Risks, PLoS, Weight Research / 15.02.2018

MedicalResearch.com Interview with: Gang Liu, PhD Postdoctoral Research Fellow Department of Nutrition Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although many approaches can be used to achieve a short-term weight loss, maintenance of weight loss has become a key challenge for sustaining long-term benefits of weight loss. Accumulating evidence has suggested that certain environmental compounds may play an important role in weight gain and obesity development. The potential endocrine-disrupting effects of perfluoroalkyl substances (PFASs), which are extensively used in many industrial and consumer products including food packaging, paper and textile coatings, and non-stick cookware, have been demonstrated in animal studies, but whether PFASs may interfere with body weight regulation in humans is largely unknown. In a 2-year POUNDS Lost randomized clinical trial that examined energy-restricted diets on weight changes, baseline plasma concentrations of major PFASs were measured among 621 overweight and obese participants aged 30-70 years. Body weight was measured at baseline, 6, 12, 18, and 24 months. Resting metabolic rate (RMR) and other metabolic parameters, including glucose, lipids, thyroid hormones, and leptin, were measured at baseline, 6, and 24 months. We found that higher baseline levels of PFASs were significantly associated with a greater weight regain, primarily in women. On average, women in the highest tertile of PFASs regained 1.7-2.2 kg more body weight than women in the lowest tertile. In addition, higher baseline plasma PFAS concentrations, especially perfluorooctanesulfonic acid (PFOS) and perfluorononanoic acid (PFNA), were significantly associated with greater decline in RMR during the first 6 months and less increase in RMR during weight regain period.  (more…)
Author Interviews, Endocrinology, JCEM, OBGYNE, Testosterone, UCSD / 24.01.2018

MedicalResearch.com Interview with: Varykina Thackray, Ph.D. Associate Professor of Reproductive Medicine University of California, San Diego MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that changes in the composition of intestinal microbes (gut microbiome) are associated with metabolic diseases. Since many women with polycystic ovary syndrome (PCOS) have metabolic dysregulation that increases the risk of developing type 2 diabetes and cardiovascular disease, we wondered whether PCOS was associated with changes in the gut microbiome and if these changes were linked to any clinical features of PCOS. We collaborated with Beata Banaszewska and her colleagues at the Poznan University of Medical Sciences in Poznan, Poland to obtain clinical data and fecal samples from 163 premenopausal women recruited for the study. In collaboration with Scott Kelley at San Diego State University, we used 16S ribosomal RNA gene sequencing and bioinformatics analyses to show that the diversity of the gut microbiome was reduced in Polish women with PCOS compared to healthy women and women with polycystic ovaries but no other symptoms of PCOS. The study confirmed findings reported in two other recent studies with smaller cohorts of Caucasian and Han Chinese women. Since many factors could affect the gut microbiome in women with PCOS, regression analysis was used to identify clinical hallmarks that correlated with changes in the gut microbiome. In contrast to body mass index or insulin resistance, hyperandrogenism was associated with changes in the gut microbiome in this cohort of women, suggesting that elevated testosterone may be an important factor in shaping the gut microbiome in women. (more…)
Author Interviews, Cancer Research, Endocrinology, Nutrition / 18.01.2018

MedicalResearch.com Interview with: Benedikt Warth, PhD, Assistant Professor Department of Food Chemistry and Toxicology University of Vienna Vienna, Austria  MedicalResearch.com: What is the background for this study? Response: The palbociclib/letrozole combination therapy was granted accelerated approval by the U.S. Food and Drug Administration in 2015 after a clinical trial showed it doubled the progression-free survival time in postmenopausal women with estrogen receptor (ER) positive, metastatic breast cancer. Letrozole blocks the production of estrogen, thus reducing the growth-promoting stimulation of ERs on breast cancer cells. Palbociclib blocks a different signaling pathway to impede cell division. The combination is now one of the standard therapies for ER-positive breast cancers. The aim of our study was twofold: Firstly, we investigated the drugs synergism at the metabolome level in MCF-7 cells to unravel the unknown underlying metabolic effects of palbociclib/letrozole mechanism of action. We used a global metabolomics approach to analyze the effects of palbociclib and letrozole individually and in combination on breast cancer cells. Metabolomics studies detail cells’ metabolomes—populations of metabolites, the small-molecule end products of cellular processes. Secondly, we aimed at deciphering the impact of the two model xenoestrogens frequently present in our diet, zearalenone and genistein, on this chemotherapy. Since these chemicals interact with the estrogen receptor we hypothesized that they may interfere with the new treatment. (more…)
Author Interviews, Endocrinology, JAMA, Menopause, OBGYNE / 13.12.2017

MedicalResearch.com Interview with: Dr. Suzanne Fenske, MD Assistant Professor of Obstetrics, Gynecology and Reproductive Science Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? What are the main findings? Response: USPSTF recommendations are based off several studies, but is mainly based off of the Women's Health Initiative. The Women's Health Initiative was a 15 year prevention study with a focus on death, disability and impaired quality of life in postmenopausal women. This study was originally performed in 1991. The USPSTF reevaluated the data along with several other studies to assess the role of hormone replacement therapy in prevention of chronic diseases such as heart disease, stroke, blood clot, gallbladder disease, dementia.  The USPSTF has found that hormone replacement therapy has some benefit in reducing the risk of fractures, and, potentially, diabetes.  The USPSTF has found that hormone replacement therapy can increase the risk of coronary artery disease, stroke, blood clot, gall bladder disease, urinary incontinence and dementia. With these risks, the USPSTF states that hormone replacement therapy should not be used as a preventative medicine, but, rather, used for treatment of symptomatic menopause and not prevention of osteoporosis or heart disease. (more…)
Author Interviews, Endocrinology, Fertility, JAMA, OBGYNE, Thyroid Disease / 13.12.2017

MedicalResearch.com Interview with: Professor Tianpei Hong, MD, PhD Of behalf of Prof. Jie Qiao and all the coauthors, Director, Department of Endocrinology & Metabolism Director, Department of Laboratory Medicine Peking University Third Hospital Beijing, China MedicalResearch.com: What is the background for this study?
  • Ÿ           Women who test positive for thyroid autoantibodies have been reported to be at 2- to 3-fold higher risk of spontaneous miscarriage than those who test negative. However, the effect of levothyroxine on miscarriage among women with positive thyroid autoantibodies and normal thyroid function has been documented in limited studies with conflicting results.
  • Ÿ           Given the substantial difficulty achieving successful pregnancy among infertile women, identifying optimal treatment for infertile women who test positive for thyroid autoantibodies is particularly important. There are a few randomized clinical trials showing a beneficial effect of levothyroxine treatment on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET). However, the sample size of those trials was rather small which may weaken the quality of the evidence.
  • Ÿ           Therefore, the Pregnancy Outcomes Study in euthyroid women with Thyroid Autoimmunity after Levothyroxine (POSTAL) study was conducted in Peking University Third Hospital to evaluate whether levothyroxine treatment initiated before IVF-ET could decrease the miscarriage rate and improve the live birth rate in infertile women who tested positive for antithyroperoxidase antibody but had normal thyroid function.
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