Dr. Layal Chaker[/caption]
Layal Chaker, MD, MSc
PhD candidate
Department of Endocrinology and Epidemiology
Erasmus Medical Center
Rotterdam, The Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The association of thyroid function with coronary heart disease is well–established but not much was known about the association of thyroid function with sudden cardiac death. We conducted the study with the hypothesis that thyroid hormone levels affect cardiovascular risk factors and therefore could also affect the risk of sudden cardiac death (SCD). We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association of high and high-normal thyroid function with SCD remained similar, suggesting that other pathways could play a role. Thyroid hormone has different effects on the cardiovascular systems and future studies should identify which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels. This could lead to better assessment of individual risk and identify possible prevention targets.
Dr. Leena Hilakivi-Clarke[/caption]
Leena Hilakivi-Clarke, PhD
Professor of Oncology
Georgetown University
Washington, DC 20057
MedicalResearch.com: What is the background for this study?
Response: About 70% of women who develop breast cancer express estrogen receptors in their cancer. These patients are treated with endocrine therapies that target estrogen receptors. Endocrine therapies are effective in half of the patients, but the other half are resistant to the treatment and recur. Prior to the start of endocrine therapy, there is no way to predict who will respond to it and who will have recurrence of breast cancer. Therefore, it is not known which patients might benefit from an additional therapy to prevent recurrence, and what that additional therapy would entail. We wondered if resistance to endocrine therapy (we used tamoxifen) is pre-programmed by maternal exposure to the estrogenic endocrine disrupting chemical ethinyl estradiol (EE2). Previously, we and others have found that EE2 and other estrogenic compounds, when given during pregnancy, increase breast cancer risk in the female offspring in animal studies and among humans. The current study was done using a preclinical animal model that was used 50 years ago to discover that tamoxifen is an effective endocrine therapy for estrogen receptor positive breast cancer patients.
Dr. Quaker Harmon[/caption]
Quaker Harmon M.D., Ph.D.
Epidemiology Branch
National Institute of Environmental Health Sciences
Research Triangle Park, NC 27709
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Vitamin D is important for bone health. In the United States many women are vitamin D deficient. Vitamin D does not naturally occur in many foods, however some foods are fortified with vitamin D. Supplements and sunshine are the most reliable sources of vitamin D.
Previous studies suggested that women using birth control pills containing estrogen had higher levels of vitamin D. These studies were generally small and were not always able to examine important factors such as time spent outside. We were interested in examining the association between hormonal contraception and vitamin D levels in a larger group of women.
We found that women who use estrogen-containing contraception had a 20% increase in their vitamin D levels. This increase was not due to time spent outside or behaviors related to choice of contraception. The magnitude of increase for hormonal contraception was smaller than for regular use of a supplement containing vitamin D.
Dr. Kejal Kantarci[/caption]
Kejal Kantarci, M.D. M.S.
Professor of Radiology
Division of Neuroradiology
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A rapid decline in estrogen with menopause may be associated with an increased risk of Alzheimer’s disease risk in women. This study was conducted in newly postmenopausal women who received 17β-Estradiol via a skin patch or conjugated equine estrogen orally or placebo.
Those who received 17β-Estradiol patch had reduced β-amyloid deposits, the plaques found in the brains of people with Alzheimer’s disease, three years after the end of the hormone therapies.
In the study, women with APOE e4 — one form of the most common gene associated with late-onset Alzheimer's disease — who received the 17β-Estradiol patch had lower levels of β-amyloid deposits than those who received placebo.
Dr. Evgenia Gourgari[/caption]
Dr. Evgenia Gourgari MD
Section on Endocrinology and Genetics, Program on Developmental Endocrinology & Genetics (PDEGEN) & Pediatric Endocrinology Inter-institute Training Program
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Bethesda, MD 20892
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Polycystic ovary syndrome (PCOS) is the most common cause of infertility among women of reproductive age ,yet the etiology of this syndrome remains unknown. Women with PCOS can have high androgens, irregular periods, cysts in their ovaries, acne, excessive facial hair. Women with PCOS are also at high risk to develop diabetes. Androgens and cortisol are hormones that produced from the adrenal glands. We wanted to investigate whether a group of women with PCOS have an adrenal disorder as underlying etiology of PCOS.
We found a group of women with PCOS produced more adrenal hormones compared to healthy women and these women also had some characteristics of micronodualr adrenal hyperplasia in their adrenals. Our findings suggest that a problem in the adrenal glands mostly involved in their steroid hormone secretion and how this is regulated may be the underlying cause of PCOS in a subgroup of women with this syndrome.
MedicalResearch.com: What should readers take away from your report?
Response: Some women with PCOS might have a problem with their adrenal gland, but more research is needed to better understand the role of adrenal glands in the development of PCOS syndrome.
Dr. Aditya Bardia[/caption]
Aditya Bardia, MD, MPH
Massachusetts General Hospital Cancer Center
Harvard Medical School
Boston, MA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: While endocrine therapy is the recommended therapy for Estrogen Receptor positive (ER+) breast cancer, the role of endocrine therapy in neoadjuvant (pre-surgical) setting is unclear. We performed this systematic review and meta-analysis to comprehensively evaluate the efficacy of neoadjuvant endocrine therapy, both alone and in combination with other therapies, compared to neoadjuvant chemotherapy for localized ER+ breast cancer. We found no statistically significant differences between the two treatments in regards to clinical response, imaging response, rates of breast conservation therapy, and achievement of pathologic complete response.
Dr Robb Rutledge[/caption]
MedicalResearch.com Interview with:
Dr Robb Rutledge
UCL Institute of Neurology and
Max Planck UCL Centre for Computational Psychiatry and Ageing Research
University College London
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Rutledge: As we get older, dopamine levels in the brain gradually decline.
Dopamine has long been associated with risk taking and we have
recently found that it is related specifically to how willing people
are to take risks for potential rewards. It is widely believed that
older people are risk averse, but this is controversial, and it is
unknown whether age-related changes in dopamine are responsible for
changes in risk taking. In this study, we tested over 25,000 people
using a smartphone app called The Great Brain Experiment where players
tried to win as many points as they could by choosing between safe and
risky options. We found that older people were less willing to takes
risks for potential rewards than young people, the same situations
dopamine is known to be involved in.
Dr. David Earnest[/caption]
David Earnest, Ph.D.
Professor in the Department of Neuroscience and Experimental Therapeutics
Texas A&M Health Science Center College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Earnest: When body clocks are disrupted, as they are when people engage in shift work or go to bed and get up at radically different times every few days, more severe ischemic strokes can result.
MedicalResearch.com: What should readers take away from your report?
Dr. Earnest: Whenever possible, go to bed and get up at the same time each day and keep regular mealtimes. If you do need to keep an irregular schedule, it is especially important to be mindful of stroke risk and try especially hard to eliminate other risk factors, such as hypertension and obesity.
Maayan Yitshak Sade[/caption]
Maayan Yitshak Sade MPH
Chief Scientific Officer
Clinical Research Center,
Soroka University Medical Center, Israel and
[caption id="attachment_24725" align="alignleft" width="125"]
Dr. Victor Novack[/caption]
Victor Novack, MD, PhD
Soroka University Medical Center and Ben-Gurion University in Beer Sheva, Israel
MedicalResearch.com: What is the background for this study?
Response: Numerous studies found association between exposure the air pollution and increased risk of cardiovascular and respiratory diseases. In recent years links were found between air pollution and diabetes as well. The scientific evidence supports a causal association between air pollution and oxidative stress, possibly involving impaired metabolism of glucose and lipids. In a recent study performed by our group, we observed a significantly increased risk for ischemic stroke among young adults, associated with air pollution exposure. Following these findings, and as a part of the possible theory linking the association air pollution exposure and cardiovascular diseases, we sought to investigate if this association might be mediated through the well-established cardiovascular risk factors such as abnormal lipid and glucose metabolism.
Dr. Judith Lechner[/caption]
A.Univ.-Prof. Dr. Judith Lechner
Div. Physiology
Medical University of Innsbruck
Innsbruck Austria
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Lechner: Women are not just small men. Sex differences affect most, if not all the organ systems in the body. Over the past decades biomedical researchers have been mainly using male models. Therefore, there is a significant gap in knowledge of female physiology except for organ functions involved in reproduction. While the necessity to fill in these gaps has been advocated, our understanding of sex and gender differences in human physiology and pathophysiology is still limited. This holds especially true for the kidneys, e.g. while international registries show that fewer women than men are in need of renal replacement therapy due to end stage renal disease, the potentially underlying causes are still not known.
The aim of our study was to find out, if hormone changes due to the female menstrual cycle would affect normal renal cells. For this purpose, urinary samples of healthy women of reproductive age were collected daily and analyzed for menstrual cycle-associated changes of marker proteins. Specifically, two enzymes (Fructose-1,6-bisphosphatase, Glutathione-S-transferase alpha) were measured, which are intracellular components of proximal tubular cells, a key population of renal cells. Upon cell damage, these enzymes are released into the urine, qualifying them as clinical markers for early detection of tubular injury. Since even in healthy persons low amounts of these enzymes can be detected in the urine, we used these marker proteins to analyze potential effects of the female hormone cycle on normal functioning of this cell population. As a result, we could detect transient increases of Fructose-1,6-bisphosphatase and Glutathione-S-transferase alpha correlating with specific phases of the female hormone cycle, namely ovulation and menses.
This finding suggests that cyclical changes of female hormones might affect renal cell homeostasis, potentially providing women with an increased resistance against kidney damages. Thus, recurring changes of sex hormone levels, as during the natural menstrual cycle, might be involved in periodic tissue re-modeling not only in reproductive organs, but to a certain extent in the kidneys as well.
Dr. Karin Ribi[/caption]
Karin Ribi, PhD, MPH
Head of Quality of Life Office
IBCSG
International Breast Cancer Study Group
Bern Switzerland
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ribi: This study investigated the quality of life (QoL) outcomes for women in the Suppression of Ovarian Function (SOFT) trial. SOFT investigated the value of adding ovarian suppression (OFS) to tamoxifen and to determine the role of the aromatase inhibitor exemestane+OFS as adjuvant (post-surgery) therapies for hormone-sensitive early breast cancer. SOFT was conducted by the International Breast Cancer Study Group (IBCSG) in over 3000 premenopausal women from more than 500 centers worldwide. The primary analysis of SOFT compared tamoxifen alone with tamoxifen+OFS in over 2000 women, and showed that adding OFS to tamoxifen did not provide a significant benefit in the overall population of premenopausal women. However, for women who were at sufficient risk for recurrence to warrant adjuvant chemotherapy and who remained premenopausal, the addition of OFS improved disease outcomes.[1]
With regard to the QoL main findings, patients on tamoxifen+OFS were more affected than patients on tamoxifen alone by hot flushes at 6 and 24 months, by loss of sexual interest and sleep disturbance at 6 months, and by vaginal dryness up to 60 months. Without prior chemotherapy, patients on tamoxifen alone reported more vaginal discharge over the 5 years than patients on tamoxifen+OFS. Symptom-specific treatment differences at 6 months were less pronounced in patients with prior chemotherapy. Changes in global QoL indicators from baseline were small and similar between treatments over the whole treatment period.
Dr. Bente Langdahl[/caption]
Bente Langdahl
Professor, Consultant, PhD, DMSc
Department of Endocrinology and Internal Medicine THG
Aarhus University Hospital
Aarhus Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Romosozumab is a humanised antibody against sclerostin currently in development for the treatment of osteoporosis. Romosozumab has a dual effect on bone; it stimulates bone formation and inhibits bone resorption. If this new treatment obtains regulatory approval and becomes available for the treatment of osteoporosis, some of the patients who will be candidates for this new treatment will already have been treated with other available treatments, for example, bisphosphonates. This study compared the effects of romosozumab and teriparatide, a currently available bone forming treatment, on bone mass, bone structure and bone strength. The results showed that the percent change from baseline in BMD at the total hip through month 12 (the primary endpoint) was significantly greater with romosozumab compared with teriparatide: 2.6 percent versus –0.6 percent, respectively (p<0.0001). For the secondary endpoints; lumbar spine BMD by DXA, total hip and femoral neck BMD by DXA and QCT and bone strength estimated by finite element analysis patients treated with romosozumab had significantly larger increases from baseline compared with those taking teriparatide, with mean differences ranging from 3.1 percent to 4.6 percent (all p-values <0.0001).
MedicalResearch.com Interview with: [caption id="attachment_23161" align="alignleft" width="125"] Dr. Maximo Maislos[/caption] Dr. Maximo Maislos MD Head of the Atherosclerosis and Metabolism Unit Department of Medicine of the Soroka University Medical Center Israel MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Maislos: When diet and exercise are insufficient, Type 2 Diabetes Mellitus patients...
Dr. Francisco Bandeira[/caption]
Francisco Bandeira,M.D.,PhD.,F.A.C.E.
Professor of Medicine and Chairman, Division of Endocrinology, Agamenon Magalhães Hospital,
University of Pernambuco Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Bandeira: We had the opportunity to evaluate a population with very high rates of sun exposure in daily life at a tropical region with abundant sunlight (UV index of 5 at 7 am and more than 10 at midday). We found that more exposure to the sun, less vitamin D deficiency, so nature “works”. But more sun exposure led to more tanned skins and despite these very high rates of sun exposure, most people were not able to achieve optimal blood levels of 25OHD (> 30 ng/ml).
Dr. Ken C. Chiu[/caption]
Ken C. Chiu, MD, FACE, FACP
Professor
Endocrinology Fellowship Training Program
Department of Clinical Diabetes, Endocrinology, and Metabolism
Diabetes and Metabolism Research Institute
City of Hope National Medical Center
Duarte, CA 91010-3000
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Chiu: The benefit of moderate alcohol consumption is well established in cardiovascular disease. However, the role of alcohol consumption in type 2 diabetes is less clear. We examined the role of alcohol consumption in type 2 diabetes using the data from the National Health and Nutrition Examination Survey 2005-1012, which is a representative US population. In the rare alcohol consumption group (< 12 drinks per year), 24.04% were diabetic while only 14.67% were diabetic in the moderate alcohol consumption (1-4 drinks per day) group (P><0.000001). In contrast, 21.05% were diabetic in the heavy alcohol consumption (≥ 5 drinks/day) group (P=0.003) when compared to the rare alcohol consumption group. Thus, in compared to the rare alcohol consumption, moderate alcohol consumption was associated with a lower risk of diabetes (OR: 0.72; 95%CI: 0.65-0.79) after adjustment for co-variates, while there was no benefit from heavy alcohol consumption (OR: 0.97; 95%CI: 0.90-1.05). Our study demonstrates that moderate alcohol consumption reduces the risk of diabetes by 28%.
Dr. Olivia Far[/caption]
Olivia Farr, Ph.D.
Instructor in Medicine
Division of Endocrinology, Beth Israel Deaconess Medical Center
330 Brookline Ave, Stoneman 820B
Boston, MA 02215
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Farr: There are two main studies. In the first, we used immunohistochemistry to analyze 22 human brain tissue samples for the presence of GLP-1 receptors, which are protein molecules that respond to the GLP hormone’s signal. We found—for the first time—that GLP-1 receptors are expressed in the human brain, including the cortex, the part of the brain responsible for higher thought.
Our second study was performed in 18 adults with type 2 diabetes. Participants received 17 days of either liraglutide, up to 1.8 milligrams, or a placebo (dummy drug) in a random order. Then after a three-week “washout” of no medication, the same participants received 17 days of the opposite treatment. Participants and investigators were unaware which treatment they received. On day 17 of each treatment, participants underwent brain scanning with functional magnetic resonance imaging (fMRI). During fMRI, participants viewed images of different foods. In response to highly desirable foods such as cake, pastries and fried foods, liraglutide decreased reward- and salience-related brain activations in the cortex compared with images of less desirable foods, such as fruits, vegetables and other low-calorie, low-fat foods.
Prof. Nancy Wayne[/caption]
Nancy L. Wayne, PhD
Professor, Department of Physiology
UCLA School of Medicine
Los Angeles, CA 90095
MedicalResearch.com editor’s note: Campbell Soup Co. will stop using the chemical Bisphenol A in its canned products by the middle of 2017 due to consumers concerns that BPA raises the risk of cancer, brain damage and hormonal problems.
Professor Nancy Wayne, is a reproductive endocrinologist and professor of physiology at UCLA. She has conducted extensive research on the health effects of the endocrine disruptors bisphenol A (BPA), a chemical widely used by manufacturers to strengthen plastic, and its replacement, bisphenol S (BPS). Professor Wayne was kind of enough to discuss the implications of the Campbell Soup Co. announcement for the readers of MedicalResearch.com.
MedicalResearch.com: What is the background for this announcement? What are the real and potential harmful effects of BPAs?
Prof. Wayne: There has been increasing research publications on the impact of BPA on body functions in animal models, human cells in culture, and associations between high levels of BPA in human urine samples and dysfunctions and diseases. a pubmed (biomedical article search engine) keyword search of bisphenol + BPA showed 39 articles published in the 1990s, 1127 articles published in the 2000s, and over 2300 articles published since January 2010. The public is much more aware of this research now — even though the message from the U.S. FDA has been consistently that low levels of BPA are not harmful (this is not the case according to independent research). Public pressure is causing companies to re-think their use of BPA in their products that could lead to environmental exposure of humans to this chemical.
BPA has been shown in animal models to alter genes in fetal heart that are known to play a role in heart diseases, leads to increased genetic abnormalities in fertilized eggs and miscarriages, increased premature birth, increases susceptibility to breast cancer, stimulates early development of the reproductive system, and increases the risk of obesity. We cannot do controlled studies in humans with toxins like we can with laboratory animals. However, there has been shown to be an association between high levels of BPA in human urine and many of the same problems seen in animals: increased body weight and fat in children, increased risk of miscarriages and premature birth, and increased incidence of prostate cancer. Although association doesn’t mean cause-and-effect, taken together with the animal studies — it is meaningful.
MedicalResearch.com Interview with: [caption id="attachment_23219" align="alignleft" width="151"] Dr. Tim Korevaar[/caption] Dr. Tim IM Korevaar, MD Epidemiology, Internal Medicine (General Medicine) Erasmus University Rotterdam, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Korevaar: In the medical literature on this topic, many studies have studied risk factors for abnormal thyroid dysfunction during...
Dr. Nancy Wayne[/caption]
Dr. Nancy Wayne, PhD
Member, Brain Research Institute
Molecular, Cellular & Integrative Physiology
GPB Home Area
Neuroscience GPB Home Area
David Geffen School of Medicine UCLA
Medical Research: What is the background for this study? What are the main findings?
Dr. Wayne: I started this work because of my concern about our continuous exposure to BPA and other endocrine disrupting chemicals. Our first study published in 2008 showed that low doses of BPA accelerated embryonic development and birth within 24 hours of exposure. We extended this work more recently by investigating the impact of BPA and BPS (a common BPA-substitute) on the timing of birth and development of the reproductive system in embryos.
Our research showed that low levels of BPS had a similar impact on the embryo as BPA. In the presence of either BPA or BPS, embryonic development was accelerated leading to abnormal stimulation of the reproductive system. Additionally, BPA caused premature birth. This is cause for concern with human health consequences to long-term exposure to low levels of potentially dozens of endocrine disrupting chemicals that are in our environment.
Dr. Marita Teng[/caption]
MedicalResearch.com Interview with:
Marita Teng, MD
Associate Professor of Otolaryngology
Head and Neck Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com Editor's note: January is Thyroid Awareness Month. In recognition, Dr. Teng discusses the thyroid gland's important role in the production of hormones that help the body regulate its metabolism. Dr. Teng also discusses the recognition of thyroid nodules and cancer.
MedicalResearch: What does the thyroid gland do? Why is it important for health?
Dr. Teng: The thyroid gland produces thyroid hormone, which is carried through the circulation to the other organs in the body. Thyroid hormone is responsible for the body’s metabolism, and therefore maintains functions such as keeping the body warm, and properly use the energy we derive from food.
MedicalResearch: What is are some signs or symptoms of an underactive or overactive thyroid?
Dr. Teng: Thyroid overactivity (hyperactivity) results in heat intolerance, weight loss, rapid heartbeat, nervousness, increased appetite, difficulty sleeping, skin thinning, and hair loss, among other symptoms. Thyroid underactivity (hypothyroidism) causes fatigue, weight gain, cold sensitivity, slowed heart rate, depression, memory impairment, and weakness, among other symptoms. It should be noted that these symptoms are all nonspecific and can certainly be caused by other medical conditions as well.
Dr. NaNa Keum[/caption]
More on Colon Cancer on MedicalResearch.com
MedicalResearch.com Interview with:
Dr. Nana Keum, PhD
Department of Nutrition
Harvard T.H. Chan School of Public Health
Boston, MA
Medical Research: What is the background for this study? What are the main findings?
Dr. Keum: Male pattern baldness, the most common type of hair loss in men, is positively associated with androgens as well as IGF-1 and insulin, all of which are implicated in pathogenesis of colorectal neoplasia. Therefore, it is biologically plausible that male pattern baldness, as a marker of underlying aberration in the regulation of the aforementioned hormones, may be associated with colorectal neoplasia. In our study that examined the relationship between five male hair pattern at age 45 years (no-baldness, frontal-only-baldness, frontal-plus-mild-vertex-baldness, frontal-plus-moderate-vertex-baldness, and frontal-plus-severe-vertex-baldness) and the risk of colorectal adenoma and cancer, we found that frontal-only-baldness and frontal-plus-mild-vertex-baldness were associated with approximately 30% increased risk of colon cancer relative to no-baldness. Frontal-only-baldness was also positively associated with colorectal adenoma.