Post-Menopausal Hormones Mitigates Effects of Stress on Cortisol and Working Memory

MedicalResearch.com Interview with:

Alexandra Ycaza Herrera, Ph.D. Postdoctoral Scholar Leonard Davis School of Gerontology Department of Psychology University of Southern California Los Angeles, Ca 90089

Dr. Herrera

Alexandra Ycaza Herrera, Ph.D.
Postdoctoral Scholar
Leonard Davis School of Gerontology
Department of Psychology
University of Southern California
Los Angeles, Ca 90089 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: ​Previous research has shown that estradiol treatment after menopause can reduce the stress response when exposed to a stressor, including the cortisol response to stress. Other work has shown that stress can impair certain types of memory​. We wanted to test whether post-menopause estradiol treatment would not only attenuate the cortisol response to stress, but if it could also reduce the negative effects of stress on memory. In particular, we tested the effects on a type of memory called working memory. Working memory allows us to maintain and update information we need to readily access in short-term memory. For example, imagine you stop at the grocery store after work and only have a mental list of the items you need to make dinner. Working memory is the memory type engaged in helping you maintain and update your mental list of items as you grab items off the shelves and check them off your list.

We recruited women through the Early versus Late Intervention Trial with Estradiol, a randomized, double-blinded, placebo-controlled clinical trial. Women who participated in our study had received nearly 5 years of either estradiol or placebo.

We found that women receiving estradiol showed significantly smaller cortisol responses to stress and less of an effect of stress on working memory than women that had been receiving placebo.

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Maternal Blood Pressure Rise During Pregnancy Linked To Increased Risk Of Childhood Obesity

MedicalResearch.com Interview with:

Duo Li, PhD Chief professor of Nutrition Institute of Nutrition and Health Qingdao University, China. 

Dr. Duo Li

Duo Li, PhD
Chief professor of Nutrition
Institute of Nutrition and Health
Qingdao University, China. 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Childhood obesity is becoming an emerging public health issue worldwide, owing to its association with a variety of health problems at younger ages in adulthood, including obesity, type 2 diabetes and cardiovascular diseases. Identification of prenatal and early life risk factors is key for curbing the epidemic of the childhood obesity.

Main finding of the present study is that among pregnant women, elevated blood pressure is associated with a greater risk of overweight and obesity for their children.

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Risk of Type 2 Diabetes Elevated in Women With PCOS – Polycystic Ovary Syndrome

MedicalResearch.com Interview with:

Dorte Glintborg Overlæge, ph.d, dr.med Endokrinologisk Afdeling M Odense Universitetshospital

Dr. Glintborg

Dorte Glintborg
Overlæge, ph.d, dr.med
Endokrinologisk Afdeling M
Odense Universitetshospital

MedicalResearch.com: What is the background for this study?

Response: Polycystic ovary syndrome (PCOS) is a common endocrine disorder. PCOS is most often defined according to the Rotterdam criteria, which include irregular ovulation, biochemical/clinical hyperandrogenism, and/or polycystic ovaries when other etiologies are excluded. PCOS is associated with insulin resistance and obesity, but data regarding development and risk factors for type 2 diabetes (T2D) in PCOS are limited.

We performed a National Register-based study on Danish women with PCOS and included data regarding T2D events according to diagnosis codes and filled medicine prescriptions (N=18,477). Three age-matched controls were included per patient (N=54,680).

MedicalResearch.com: What are the main findings?

Response: We found that the risk for development of type 2 diabetes was 4 times increased in women with PCOS compared to controls. The median age at diagnosis of  type 2 diabetes was 31 years in women with PCOS compared with 35 years in controls suggesting that T2D was diagnosed 4 years earlier in PCOS. Increasing body mass index was associated with increased risk of development of T2D, whereas higher number of births was negatively associated with development of type 2 diabetes.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Further studies are needed regarding predictors of  type 2 diabetes in PCOS. Our data support a considerable increased risk for type 2 diabetes in obese women with PCOS. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Development and risk factors of type 2 diabetes in a nationwide population of women with polycystic ovary syndrome

Katrine Hass Rubin Dorte Glintborg Mads Nybo Bo AbrahamsenMarianne Andersen

The Journal of Clinical Endocrinology & Metabolism, jc.2017-01354,https://doi.org/10.1210/jc.2017-01354

Published29 August 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

 

 

 

 

Risks of Surgery For Thyroid Cancer Higher Than Expected

MedicalResearch.com Interview with:

Megan Rist Haymart MD Assistant Professor University of Michigan

Dr. Haymart

Megan Rist Haymart MD
Assistant Professor
University of Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Thyroid cancer is typically treated with thyroid surgery. It is common practice for physicians to inform patients that the risk of vocal cord paralysis or hypoparathyroidism with thyroid surgery is 1-3%.

However, most of these estimates are based on single institution studies with high volume surgeons. In our study we evaluated surgical risks in a population-based cohort. Using the Surveillance, Epidemiology, and End Results-Medicare database, we found that 6.5% of thyroid cancer patients developed general post-operative complications (fever, infection, hematoma, cardiopulmonary and thromboembolic events) and 12.3% developed thyroid surgery specific complications (hypoparathyroidism/hypocalcemia, vocal cord/fold paralysis).

Older patient age, presence of comorbidities, and advanced stage disease were associated with the greatest risks of surgical complications.

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Bisphenol A May Promote Obesity By Interfering with Leptin Early in Life

MedicalResearch.com Interview with:
Alfonso Abizaid PhD

Department of Neuroscience
Carleton University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Bisphenol A (BPA) is a compound considered to be a potential environmental hazard and an endocrine disruptor. We have found an association between exposure to BPA at levels that are considered safe by Health Canada and the EPA early in life, and the development of obesity. In addition, we found that this propensity to develop obesity is due to under development of the hypothalamic projection field of POMC neurons, a set of neurons that regulate satiety and stimulate metabolic rate.

In this paper we replicate those findings and also show that this abnormal development is due to BPA altering the secretion of the hormone leptin at critical times where this hormone is important for the post-natal development of these POMC neurons.

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Gut Inflammation & Bacterial Changes Linked to Type 1 Diabetes

MedicalResearch.com Interview with:

Prof Lorenzo Piemonti, MD Professor of Endocrinology Deputy Director, Diabetes Research Institute (SR-DRI) Head, Beta Cell Biology Unit Vita-Salute San Raffaele University, San Raffaele Scientific Institute Milano Italy

Prof Lorenzo Piemonti

Prof Lorenzo Piemonti, MD
Professor of Endocrinology
Deputy Director, Diabetes Research Institute (SR-DRI)
Head, Beta Cell Biology Unit
Vita-Salute San Raffaele University,
San Raffaele Scientific Institute
Milano Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The potential role of gut inflammation and microbiome is becoming a hot topic in the field of diabetes. Several very recent publications report the presence of intestinal abnormalities associated with autoimmune diabetes in both experimental rodent models and patients. We have previously published that, compared to healthy subjects, patients with type 1 diabetes or at high risk of developing type 1 diabetes shows increased intestinal permeability.

Among the factors that may modify the intestinal barrier and impact on its immune activation, the gut microbiota is at present the main suspect. Our study is the first in literature that had the opportunity to analyze the inflammatory profile, the microbiome and their correlation on duodenum biopsies of patients with type 1 diabetes, in comparison with patients with celiac disease and healthy controls. Previous papers pointed out a significant difference in the composition of the stool microflora in subjects with autoimmune diabetes.

A major advancement of our work comes from the direct analysis of small intestine, instead of studies on stool samples. In fact, because of their close functional and spatial relationships, as well as a shared blood supply, it is logical to consider the duodenum and the pancreas correlated. We found big differences among the groups: gut mucosa in diabetes shows a peculiar signature of inflammation, a specific microbiome composition and we also discovered a strong association between some analysed inflammatory markers and specific bacteria genera. We think that our data add an important piece to disentangle the complex pathogenesis of type 1 diabetes and more generally of autoimmune diseases.

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Clinicians Found To Have Inadequate Training in Transgender Health

MedicalResearch.com Interview with:
Caroline J. Davidge-Pitts, M.B., Ch.B

Mayo Clinic
Rochester, Minn.

MedicalResearch.com: What is the background for this study?

Response
: The awareness of transgender healthcare issues has increased, leading to improved coverage of both hormonal and non-hormonal therapies. In endocrinology practices, there is an increased demand for providers who are competent in these areas. We wanted to assess the current status of knowledge and practice in transgender health amongst our current and future endocrinologists.

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Menopausal Hormone Therapy Benefits Bone Health For Several Years After Discontinuation

MedicalResearch.com Interview with:

Dr Georgios Papadakis FMH, Médecin InternenMédecin assistant Service d'endocrinologie, diabétologie et métabolisme Lausanne

Dr Georgios Papadakis

Dr Georgios Papadakis
FMH, Médecin InternenMédecin assistant
Service d’endocrinologie, diabétologie et métabolisme
Lausanne

MedicalResearch.com: What is the background for this study?

Response: This study was mainly motivated by the absence of available data on the effect of menopausal hormone therapy (MHT) on bone microarchitecture, as well as contradictory results of previous trials regarding the persistence of a residual effect after MHT withdrawal.

We performed a cross-sectional analysis of 1279 postmenopausal women aged 50-80 years participating in OsteoLaus cohort of Lausanne University Hospital. Participants had bone mineral density (BMD) measurement by dual X-ray absorptiometry (DXA) at lumbar spine, femoral neck and total hip, as well as assessment of trabecular bone score (TBS), a textural index that evaluates pixel grey-level variations in the lumbar spine DXA image, providing an indirect index of trabecular microarchitecture.

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Hypoglycemia Linked To Increased Mortality in Hospitalized Patients

MedicalResearch.com Interview with:
Amit Akirov, MD
Institute of Endocrinology
Rabin Medical Center- Beilinson Hospital
Petach Tikva, Israel

MedicalResearch.com: What is the background for this study?

Response: As hypoglycemia is common among hospitalized patients with and without diabetes mellitus, we aimed to investigate the association between spontaneous and insulin-related hypoglycemia including severe hypoglycemia and all-cause mortality among a large cohort of hospitalized patients.

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Hormone Combination Effective For Male Contraception But With Many Side Effects

MedicalResearch.com Interview with:
Mario Philip Reyes Festin, MD

World Health Organization
Geneva, Switzerland. 

MedicalResearch.com: What is the background for this study?

Response: Researchers are trying to identify a hormonal male contraceptive that is effective, reversible, safe, acceptable, affordable, and available. Most of the research has been done either by groups of university researchers. However, in the 1990s, WHO undertook two multi-center, multinational studies.

The studies were unable to provide evidence to support the development of a commercially viable, and user-acceptable product.

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Even With Normal TSH, Some Patients Still Feel Hypothyroid

MedicalResearch.com Interview with:

Antonio C. Bianco, MD, PhD Rush University Medical Center

Dr. Antonio C. Bianco

Antonio C. Bianco, MD, PhD
Rush University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The standard of care for patients with hypothyroidism is treatment with levothyroxine. The dosage of levothyroxine is adjusted for each patient with the goal of normalizing blood levels of TSH. About 15% of the patients treated this way exhibit variable degrees of residual symptoms, despite having a normal TSH level. These symptoms include difficulty losing weight, low energy and depression. However, given the subjective nature of these complains and that the blood levels of TSH are normal, many times such symptoms are dismissed by physicians as non-thyroid related.

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Urinary Citrate Excretion May Be Indirect Biomarker of Bone Health

MedicalResearch.com Interview with:
Jonas Esche

Dipl.-Mol. Biomed
University of Bonn
Institute of Nutritional and Food Sciences
DONALD Study

MedicalResearch.com: What is the background for this study?

Response: Modern western diets increase diet-dependent acid load and net acid excretion which are suggested to have adverse long-term effects on bone. Urinary potential renal acid load (uPRAL) is an established parameter to assess nutritional acid load. Urinary citrate, on the other hand, integrates nutritional and also systemic influences on acid-base homeostasis with high citrate indicating prevailing alkalization.
Against this background urinary citrate excretion was used as a new index of acid-base status and its relationship with bone strength and long-term fracture risk was examined.

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Nighttime Hot Flashes With Sleep Disruption Linked To Depressive Symptoms During Menopause

MedicalResearch.com Interview with:

Hadine Joffe, MD, MSc Associate Professor of Psychiatry, Harvard Medical School Vice Chair for Psychiatry Research Director of Division of Women's Mental Health / Dept of Psychiatry / Brigham and Women’s Hospital Director of Psycho-Oncology Research / Dept of Psychosocial Oncology and Palliative Care /Dana Farber Cancer Institute www.brighamwharp.org

Dr. Hadine Joffe

Hadine Joffe, MD, MSc
Associate Professor of Psychiatry, Harvard Medical School
Vice Chair for Psychiatry Research
Director of Division of Women’s Mental Health / Dept of Psychiatry / Brigham and Women’s Hospital
Director of Psycho-Oncology Research / Dept of Psychosocial Oncology and Palliative Care /Dana Farber Cancer Institute
www.brighamwharp.org

MedicalResearch.com: What is the background for this study?

Response: We conducted this study to advance our understanding about causes of mood disturbance in the menopause transition that are specifically related to menopause. We used an experimental model to dissect out the contributions of hot flashes and sleep disturbance from contribution of changing levels of estrogen because hot flashes, sleep problems, and estrogen fluctuations co-occur and are difficult to distinguish from one another. Understanding whether hot flashes and/or sleep disturbance are causally related to mood disturbance will help us identify who is at risk for mood changes during the menopause transition. This is incredibly important now that we are finding effective non-hormonal treatments for hot flashes and sleep disruption.

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Intestinal Microbiome Linked to Obesity and Fat Storage in Children

MedicalResearch.com Interview with:

Nicola Santoro, MD, PhD Associate Research Scientist in Pediatrics (Endocrinology) Yale University

Dr. Nicola Santoro

Nicola Santoro, MD, PhD
Associate Research Scientist in Pediatrics (Endocrinology)
Yale University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study start from previous observations showing an association between the gut microbiota and obesity.

Similarly to what previously described in adults and in children, we found an association between the gut microbiota and obesity. We took a step further and also observed that the gut flora is associated to body fat partitioning (amount of fat in the abdomen). Moreover, we observed that the effect of microbiota could be mediated by the short chain fatty acids a product of gut flora.

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Vitamin D Levels Fall When Estrogen-Containing Birth Control Pills Stopped

MedicalResearch.com Interview with:

Quaker Harmon M.D., Ph.D. Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park, NC 27709

Dr. Quaker Harmon

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.

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Sleep Duration Affects Diabetes Risk Differently in Men and Women

MedicalResearch.com Interview with:

Dr. Femke Rutters Department of Epidemiology and Biostatistics Vrije Universiteit Medical Centre Amsterdam, The Netherlands; EMGO+ Institute for Care Research

Dr. Femke Rutters

Dr. Femke Rutters
Department of Epidemiology and Biostatistics
Vrije Universiteit Medical Centre
Amsterdam, The Netherlands;
EMGO+ Institute for Care Research

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In the past 10 years the interest in sleep as a possible cause for obesity/diabetes has risen. But data up until now used mainly self-reported sleep and simple measures of diabetes (related parameters), such as fasting glucose. A study on well-measured insulin sensitivity and beta-cell function was lacking. Such a study could provide more information on the pathophysiology.

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Malignant Thyroid Nodules Less Common But More Aggressive With Age

Erik K. Alexander, MD FACP Chief, Thyroid Section, Division of Endocrinology Brigham & Women's Hospital Associate Professor of Medicine, Harvard Medical School

Dr. Erik Alexander

MedicalResearch.com Interview with:
Dr. Erik K. Alexander, MD FACP
Chief, Thyroid Section, Division of Endocrinology
Brigham & Women’s Hospital
Associate Professor of Medicine, Harvard Medical School

Medical Research: What is the background for this study? What are the main findings?

Dr. Alexander: Thyroid nodular disease has become an increasingly common medical illness, with prevalence reported to range between 26-67% in the adult.  Though advancing age is known to influence the formation of thyroid nodules, their precise relationship remains unclear.  Furthermore, it is uncertain whether age influences the risk that any thyroid nodule may prove cancerous.  Thus we conducted a study to determine the impact of patient age on nodule formation, the number of thyroid nodules, and risk of thyroid malignancy.

Medical Research:  What are the main findings?

Dr. Alexander: Our study is a prospective cohort analysis of consecutive adults who presented for evaluation of nodular disease from 1995-2011 at Brigham and Women’s Hospital, Boston, MA.  6,391 patients underwent thyroid ultrasound and fine needle aspiration that resulted in 12,115 thyroid nodules ≥1 cm.  Patients were stratified into six age groups and compared using sonographic, cytologic, and histologic endpoints.
We found that the prevalence of thyroid nodular disease increases with advancing age.  The mean number of nodules at presentation increased from 1.5 in the youngest cohort (ages 20–30) to 2.2 in the oldest cohort (>70 years).  In contrast, the risk for malignancy in a newly identified nodule declined with advancing age.  Thyroid cancer incidence per patient was 22.9% in the youngest cohort, but 12.6% in the oldest cohort.  Despite a lower likelihood of malignancy, identified cancers in older patients demonstrated a more aggressive cancer subtype.  While nearly all malignancies in younger patients were well-differentiated, older patients were more likely to have higher risk papillary thyroid cancer variants, poorly differentiated cancer, or anaplastic carcinoma.

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Growth Hormone Reduced Fractures in Osteoporosis Patients

MedicalResearch.com Interview with:
Emily Krantz (né Amundson) MD
Södra Älvsborgs Hospital
Borås, Sweden

Medical Research: What is the background for this study? What are the main findings?

Response: This study is a 10-year follow up of a double-blind placebo controlled trial in which women with post menopausal osteoporosis received Growth Hormone (GH) for 3 years (Landin-Wilhelmsen JBMR 2003;18:393-404). Positive effects of the treatment on the patients bone mineral density and bone mineral content were seen after another 7 years. Furthermore and most interestingly, fracture incidence decreased dramatically from 56% to 28% (p=.0003) in the osteoporosis patients while fractures increased significantly in the control group, from 8% to 32% (p=.0008). Health Related Quality of Life was also measured throughout the study’s duration and it did not change nor did it differ from the control group.

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Overnight Sleep Loss Can Have Long Term Metabolic Consequences

Jonathan Cedernaes M.D., Ph.D. Department of Neuroscience Uppsala University SwedenMedicalResearch.com Interview with:
Jonathan Cedernaes M.D., Ph.D.
Department of Neuroscience
Uppsala University Sweden

Medical Research: What is the background for this study? What are the main findings?

Dr. Cedernaes: Previous studies have demonstrated that experimental sleep loss and simulated shift work (i.e. misalignment of circadian rhythms) reduces energy expenditure and insulin sensitivity, providing links to why sleep loss may increase the risk of e.g. type-2 diabetes and obesity. Such phenotypes have also been observed in animals in which clock genes are ablated. Clock genes regulate the circadian rhythms of all cells and variants in these have also been associated with increased risk of obesity, insulin resistance and type-2 diabetes in humans. Almost no study has however investigated whether overnight wakefulness – mimicking a situation which recurrently occurs in shift work – can affect the expression of such clock genes in metabolically important tissues, i.e. adipose tissue and skeletal muscle, in humans. Such gene expression changes may both acutely and more long-term be regulated by changes in methylation, i.e. an epigenetic change, which have been found in blood of e.g. shift workers and in e.g. adipose tissue of type-2 diabetic subjects. However, whether sleep loss can lead to epigenetic changes has been unknown, and therefore also whether this could affect genes important for metabolism, such as the core clock genes which are essential for orchestrating and synchronizing downstream metabolic processes according to our circadian rhythms.

With this background in mind, I and associate professor Christian Benedict set out to conduct a study to investigate how one night of sleep loss altered gene transcription and methylation of core clock genes in adipose tissue and skeletal muscle, and whether this would be reflected at the systemic level by an impaired glucose tolerance test in healthy young individuals.

For the study, we had 15 participants undergo two almost 2-day long sessions in our lab, with the first night of each session serving as a baseline or habituation night, with a normal sleep period. On the second night, in random order, participants slept a full night (8.5 hours) in one session, and were kept awake the entire night while being bed-restricted in the other of two sessions. After each of these conditions, we took biopsies in the fasting condition from the subcutaneous adipose tissue and the skeletal muscle.

In collaboration with researchers from the Karolinska Institute, Gothenburg University and the German Institute of Human Nutrition, we were able to observe transcriptional repression of clock genes in the muscle, but not in the adipose tissue following sleep loss compared with normal sleep. Instead, we found methylation of regulatory elements of clock genes to be increased in the adipose tissue but not the skeletal muscle following sleep loss compared with normal sleep. Finally, we observed that participants had an impaired glucose tolerance test when they had been kept awake as compared with their response after sleep. Continue reading

Menopausal Women Accumulate Fat…..Around Their Hearts

Samar R. El Khoudary, Ph.D., M.P.H. Assistant professor Graduate School of Public Health Department of Epidemiology University of Pittsburgh MedicalResearch.com Interview with:
Samar R. El Khoudary, Ph.D., M.P.H.

Assistant professor
Graduate School of Public Health Department of Epidemiology
University of Pittsburgh

Medical Research: What is the background for this study?

Dr. El Khoudary: Cardiovascular disease is the leading cause of death in women, and it increases after age 50 – the average age when a woman is going through menopause. Weight gain in women during and after menopause has long been attributed to aging, rather than menopause itself. However, recent research identified changes in body fat composition and distribution due to menopause-related hormonal fluctuations.

No previous study had evaluated whether those changes in fat distribution during menopause affect cardiovascular fat. Increased and excess fat around the heart and vasculature can be more detrimental than abdominal fat, causing local inflammation and leading to heart disease. Doubling certain types of cardiovascular fat can lead to a more than 50 percent increase in coronary events. My team and I investigated whether there may be a link between menopause and cardiovascular fat using data from 456 women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women averaged about 51 years of age and were not on hormone replacement therapy.

Medical Research: What are the main findings?

Dr. El Khoudary: Our study is the first to find that  late- and post-menopausal women have significantly greater volumes of fat around their hearts than their pre-menopausal counterparts. As concentrations of the sex hormone estradiol – the most potent estrogen – declined during menopause, greater volumes of cardiovascular fat were found. The finding held even after my colleagues and I took into account the effects of age, race, obesity, physical activity, smoking, alcohol consumption, medication use and chronic diseases. Continue reading

Panel Recommends Improvements in Estrogen Testing Accuracy

MedicalResearch.com Interview with:
Hubert W. Vesper, PhD

Director, Clinical Standardization Programs in the National Center for Environmental Health, Centers for Disease Control and Prevention
Co-author, “Measuring Estrogen Exposure and Metabolism: Workshop Recommendations on Clinical Issues”
Co-chair of the PATH Steering Committee

Medical Research: What is the background for this study? What are the main findings?

Dr. Vesper: Accurate data on estrogen levels are needed to ensure appropriate and effective patient care. Research studies found high inaccuracies among different estrogen tests, especially at low estrogen levels commonly observed in postmenopausal women, men and children.

Accurate estrogen measurements can be achieved through standardization. Stakeholders should support standardization efforts of the Centers for Disease Control and Prevention (CDC) or alternative strategies to arrive at estrogen measurement methods that are accuracy-based and reliable.

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Diabetic Severity May Predict Risk of Dementia

MedicalResearch.com Interview with:
Wei-Che Chiu, MD, PhD
National Taiwan University College of Public Health,
Cathay General Hospital and Fu Jen Catholic University
Taipei, Taiwan

Medical Research: What is the background for this study?

Response: Diabetes mellitus is a common risk factor for dementia and accounts
for 6–8% of all cases of dementia in older populations. Cognitive
impairment is associated with the presence of diabetic complications
and diabetic severity, but the effects of diabetic severity on
dementia are unclear. Our study was to investigate the association
between the severity and progress of diabetes and the risk of
dementia.

Medical Research: What are the main findings?

Response: The diabetic severity and progression reflected the risk
of dementia, and the early progress in diabetic severity could predict
the risk of dementia in new-onset diabetic patients.

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Ejaculatory Issues Common and Not Helped By Testosterone Treatment

Darius A. Paduch, MD, PhDAssociate  Professor of Urology and Reproductive Medicine Director Sexual Health and Medicine Research Director of Male Infertility Fellowship Co-Director Male Infertility Genetics Laboratory Weill Cornell Medical College Dept of Urology New York, NY 10065MedicalResearch.com Interview with:
Darius A. Paduch, MD, PhD
Associate  Professor of Urology and Reproductive Medicine
Director Sexual Health and Medicine
Research Director of Male Infertility Fellowship
Co-Director Male Infertility Genetics Laboratory
Weill Cornell Medical College
Dept of Urology
New York, NY 10065

Medical Research: What is the background for this study? What are the main findings?

Dr. Paduch: Ejaculatory dysfunction, inability to ejaculate or delayed ejaculation affects 10-8% of men. Inability to ejaculate either intravaginally or at all is independent of erectile function.

Men with normal erection may take very long time to ejaculate (>30 min) or not able to ejaculate at all. The men in our study had either normal erections or minimal erectile dysfunction.

Men of all ages have spontaneous erections but don’t ejaculate just from erection, it is progression of arousal and activation of spinal cord motor generator for ejaculation which is necessary for ejaculation.

One of important factors in our ability to ejaculate is testosterone (T), testosterone allows for normal function of CNS centers for ejaculation, it is a modulator and is necessary; preadolescent boys don’t ejaculate because their spinal cord centers for ejaculations are not mature – process dependent on testosterone. However testosterone is just one of many neurotransmitters and hormones needed of normal ejaculation.

Actually our study showed that in men who achieved normal levels of testostosterone the ejaculatory function have improved. As this was first double blinded and randomized clinical trial we had to report our results based on radomization to testosterone treatment or placebo. Unfortunately only 70-80% of men treated with topical testosterone preparation will achieve normal testosterone level , we simply didn’t reach statistical significance based on randomization and  considering relatively low number of patients in each group. But in men who achieved normal testosterone levels the difference was statistically significant.

Testosterone should not be used to treat any conditions, including ejaculatory dysfunction, in absence of low testosterone  level.

EjD is very common but it bares significant embarrassment stigma, it is difficult for the couple to bear fact that male partner can’t ejaculate, it also creates issues within couple and question about attraction and fidelity.

We have previously showed that treatment with tadalafil improves ejaculatory and orgasmic dysfunction and these data has been published.

This study was focused on effect of testosterone, but its main significance was it’s design: we developed new tools to assess ejaculatory function and learned a lot about when patients or their partners start to be bothered by EjD. If time to ejaclate takes > 30 min

We are now looking into novel and available pharmacotherapy modulating dopaminergic and canabioid signaling and reward mechanisms. I am also very excited about our potential work in direct spinal cord motor generator nano stimulator, this could be very useful for men with spinal cord injuries and diabetic patients. We paved the road for others and I am sure new treatments are just a matter of time.

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Diabetes Medication May Improve Cardiac Profile Of HIV Patients on Antiretroviral Therapy

Kevin Yarasheski, PhD Assistant Director, Biomedical Mass Spectrometry Research Facility Professor of Medicine, Cell Biology & Physiology, Physical Therapy Washington University School of MedicineMedicalResearch.com Interview with:
Kevin Yarasheski, PhD
Assistant Director, Biomedical Mass Spectrometry Research Facility
Professor of Medicine, Cell Biology & Physiology, Physical Therapy
Washington University School of Medicine

Medical Research: What is the background for this study?

Dr. Yarasheski:   People living with HIV and taking combination antiretroviral therapy (cART) have successfully reduced the amount of HIV virus in their blood and have partially reconstituted their immune system (CD4+ T-cell count >250 cells/µL).  Despite this, many still experience residual immune cell activation and inflammation that is believed to increase HIV morbidity (non-AIDS conditions e.g., CVD, T2DM, obesity, liver fat, bone loss, dementia) and mortality.  Scientists are seeking safe and effective interventions for residual immune cell activation and inflammation, that have the potential to reduce non-AIDS complications that threaten quality and quantity of life among HIV infected adults.

We have been testing the safety and efficacy of sitagliptin in people living with HIV; a dipeptidyl peptidase 4 inhibitor that is FDA approved for treating T2DM, and appears to have favorable anti-inflammatory and immune modulatory properties that might specifically benefit people living with HIV and experiencing cardiometabolic complications associated with residual immune cell activation and inflammation.

Medical Research: What are the main findings?

Dr. Yarasheski:   In a randomized, double-blinded, placebo controlled 8-wk trial, we found that sitagliptin had beneficial anti-inflammatory, immune regulatory, hematopoietic progenitor cell mobilizing, and glucose lowering effects in cART-treated virally suppressed HIV adults with impaired glucose tolerance.  Sitagliptin improved glucose tolerance (a risk factor for CVD), reduced circulating and adipose-specific inflammatory markers (risk factors for obesity, T2DM, liver fat accumulation, and CVD), and increased the number of blood stem cells that can repair damage and inflammation in the vascular walls.

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Osteoporosis May Increase Risk of Hearing Loss

Dr. Kai-Jen Tien MD Division of Endocrinology and Metabolism, Department of Internal Medicine Chi Mei Medical Center, Tainan, TaiwanMedicalResearch.com Interview with:
Dr. Kai-Jen Tien MD
Division of Endocrinology and Metabolism, Department of Internal Medicine
Chi Mei Medical Center, Tainan, Taiwan

Medical Research: What is the background for this study? What are the main findings?

Response: Previous studies investigating the relationship between osteoporosis and sudden sensorineural hearing loss were rare. Most of the studies were of small sample size, or cross-sectional designs and their results were inconclusive. Our population-based study found an approximately 1.76-fold increase in the incidence of sensorineural hearing loss for patients with osteoporosis compared with the comparison group.Patients with more severe osteoporosis may have a higher risk of SSNHL than patients with osteoporosis of milder severity.

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Night Owls May Have Increased Risk of Metabolic Syndrome and Diabetes

CDC- sleepMedicalResearch.com Interview with: Nan Hee Kim M.D., Ph.D., Professor
Korea University Ansan Hospital,
Gojan1-dong, Danwon-gu, Gyunggi-do, Korea

MedicalResearch: What is the background for this study?

Dr. Nan Hee Kim: Many individuals in modern society experience a discrepancy between social and biological time. Especially during the work or school week, we are often forced to be awake against our preferred time. In addition, the increase of light, TV, computer and internet make people stay up late at night. However, night owls (evening persons) have been reported to have more health and behavioral problems than morning persons. Evening persons experience eating disorders, negative mood and insufficient sleep compared to morning persons. They initiate sleep later in the night but need to wake up earlier than their biologic morning due to social demands. There is abundant evidence that short sleep duration and insomnia are significant risk factors for obesity and diabetes. Therefore, we feel the necessity to reveal whether evening persons are associated with metabolic abnormalities in the general population.

MedicalResearch: What are the main findings?

Dr. Nan Hee Kim: In middle-aged adults, people who stayed up late had a 1.7-fold increased risk for type 2 diabetes and metabolic syndrome, and a 3.2-fold increase in risk for sarcopenia as compared with morning persons, independent of sleep duration and lifestyle. Evening persons were associated with reduced muscle mass in men and increased fat mass including visceral fat in women.

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Low Vitamin D in Childhood Linked To Early Atherosclerosis

MedicalResearch.com Interview with:
Markus Juonala, MD, PhD
University of Turku Finland

Medical Research: What is the background for this study? What are the main findings?

Response: Earlier studies suggest that low vitamin D levels may be associated with cardiovascular disease. We wanted to study whether low childhood vitamin levels predict carotid intima-media thickness, a marker of early atherosclerosis, in adulthood. We observed that those children with vitamin D in lowest quartile had increased risk for high carotid intima-media thickness.

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PCOS Linked To Increased Hospitalizations, Infertility, Diabetes and Obesity

Roger Hart MD  FRANZCOG MRCOG CREI Winthrop Professor of Reproductive MedicineSchool of Women's and Infants Health Director of Fertility Specialists of Western Australia The University of Western Australia Perth Western Australia 6008MedicalResearch.com Interview with:
Roger Hart MD  FRANZCOG MRCOG CREI

Winthrop Professor of Reproductive MedicineSchool of Women’s and Infants Health
Director of Fertility Specialists of Western Australia
The University of Western Australia Perth Western Australia 6008

Medical Research: What is the background for this study? What are the main findings?

Dr. Hart: PCOS is a very common condition affecting approximately 1 in 12 women and has an estimated annual impact upon the health system in the USA of up to $4.36 billion per year. PCOS is a condition that often manifests itself early in girls life with menstrual problems in adolescence and may lead to reduced fertility in later life due to problems with ovulation. Previous studies have suggested that women with this condition may have other problems in later life, however they have generally been small studies over a short duration. We studied women from 15 years of age, who were admitted to a hospital in Western Australia where a diagnosis of PCOS was recorded on admission. We compared them to women who did not have a PCOS diagnosis recorded on admission using our state-wide hospital database system data linkage.

The medical records of 2,566 women with a PCOS diagnosis were followed from 1980 onwards until an average of almost 36 years, and these women were matched to 25,660 women without PCOS.

Women with PCOS on average had twice as many hospital admissions and unfortunately were twice as likely to die during the study period.

As expected women with PCOS women had a higher rate of menstrual problems and infertility, and require IVF treatment, have a miscarriage or an ectopic pregnancy, and ultimately require surgical intervention for heavy periods and a hysterectomy.

In pregnancy women with PCOS were more likely to deliver preterm or have a stillbirth.

In addition women with PCOS were four times more likely to develop late onset diabetes, even after taking into consideration obesity. These women wore more likely to have problems with blood pressure and ischemic heart disease, despite being relatively young. They were more likely to develop a deep vein thrombosis and have a diagnosis of asthma.

With regard to mental health women with PCOS were twice as likely to have a diagnosis of stress and anxiety and depression. They were more likely to be a victim of self-harm and be involved with a land transport accidents.

With regard to cancer; cervical cancer was diagnosed less frequently in women with PCOS, but they had an increased risk of cancer of the womb. The incidence of breast and skin cancers was no different between the groups.

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Hot Flashes Linked With Increased Risk of Hip Fracture

Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, CA 90024MedicalResearch.com Interview with:
Carolyn J. Crandall, MD, MS
Professor of Medicine
David Geffen School of Medicine
UCLA Medicine/GIM
Los Angeles, California 90024

Medical Research: What is the background for this study? What are the main findings?

Dr. Crandall: In a large group of postmenopausal women aged 50-79, we found that women who reporting having hot flashes at baseline had increased risk of hip fracture during the subsequent 8 years of observation, nearly double the risk compared with women who did not have hot flashes at baseline.
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Recommended Osteoporosis Screening May Not Effectively Screen Younger Patients

Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, CA 90024MedicalResearch.com Interview with:
Carolyn J. Crandall, MD, MS
Professor of Medicine
David Geffen School of Medicine at University of California
UCLA Medicine/GIM Los Angeles, CA 90024

Medical Research: What are the main findings of the study?

Dr. Crandall: Clinical guidelines recommend that women aged ≥ 65 years should be screened for osteoporosis.  However, for younger postmenopausal women aged between 50 and 64 years, the United States Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women who have a 10-year predicted risk of osteoporosis fracture that is ≥9.3%.  We tested the ability the USPSTF strategy, and two other strategies (called OST and SCORE), to distinguish between women who did and did not experience a fracture in the subsequent 10 years.  We found that the USPSTF strategy did not identify the majority of who experienced osteoporotic fracture in the subsequent 10 years.  Especially in women aged 50-54 years, the USPSTF strategy identified fewer than 5% of women who experienced fracture over 10-year follow-up.

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Abnormal Lipid Levels Linked To Greater Risk of Prostate Cancer Recurrence

Emma H. Allott PhD Division of Urology, Department of Surgery, Duke University School of Medicine Cancer Prevention, Detection, and Control Program, Duke Cancer Institute Division of Urology, Veterans Affairs Medical Center Durham Durham, North Carolina.MedicalResearch.com Interview with:
Emma H. Allott PhD
Division of Urology, Department of Surgery, Duke University School of Medicine
Cancer Prevention, Detection, and Control Program, Duke Cancer Institute Division of Urology
Veterans Affairs Medical Center Durham Durham, North Carolina.

Medical Research: What are the main findings of the study?

Dr. Allott: Relative to normal triglyceride levels, high triglycerides (≥150 mg/dl) were associated with 35% increased risk of prostate cancer recurrence. In addition, we found that each 10 mg/dl increase in total serum cholesterol above the abnormal cut-off value of 200 mg/dl was associated with a 9% increased risk of prostate cancer recurrence, while each 10 mg/dl increase in HDL (high density lipoprotein; “good” cholesterol) below the abnormal cut-off value of 40 mg/dl was associated with a 39% increased risk of prostate cancer recurrence. These findings suggest that normalization, or even partial normalization, of serum lipid levels among men with dyslipidemia may reduce the risk of prostate cancer recurrence.
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Going Braless Doesn’t Increase Risk of Breast Cancer

MedicalResearch.com Interview with:
Lu Chen, MPH
Researcher in the Public Health Sciences Division
Fred Hutchinson Cancer Research Center
Doctoral student in the Department of Epidemiology
University of Washington School of Public Health

Medical Research: What are the main findings of the study?

Dr. Chen: We found no evidence that wearing a bra is associated with breast cancer risk. Further, breast cancer risk was not impacted by bra wearing frequency, wearing a bra with an underwire, or starting to wear a bra at a young age.

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Bariatric Surgery May Improve Brain Metabolism In Obese Patients

MedicalResearch.com Interview with:
Cintia Cercato, MD, PhD and
Emerson Leonildo Marques

University of São Paulo in Brazil

Medical Research: What are the main findings of the study?

Answer: The major findings are that the cerebral metabolism of the obese compared to normal weight people is increasing. The fact that it can be increased means a greater chance of Alzheimer‘s disease, but bariatric surgery can reduce cerebral metabolism of obese.
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Even Modest Exercise May Decrease Breast Cancer Risk

MedicalResearch.com Interview with:
Dr Sylvie Mesrine, Gynecologist, MD
Inserm, CESP Centre for Research in Epidemiology and Population
Health, U1018, Nutrition, Hormones and Women’s Health Team,
Villejuif, France.

Medical Research: What are the main findings of the study?

Answer: We wanted to disentangle the effect of recent physical activity (within the
previous four years) from the effect of past physical activity (5-9 years
earlier) on postmenopausal breast cancer risk. Our most important finding
was that recreational/transport physical activity (including walking,
cycling and engaging in other sports), even of modest intensity, seemed to
have a rapid impact on breast cancer risk: it was quite rapidly associated
with a decrease in breast cancer risk, which was however attenuated when
activity stops. To our knowledge, our study is the first to independently
assess the association between breast cancer risk and recreational physical
activity both 5 to 9 years earlier and within the previous 4 years.
Furthermore, the association of recent recreational physical activity and
breast cancer risk decrease was observed whatever the recent levels of
gardening or do-it yourself activities.
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Brain Reward System Underactive In Some Overweight People

Dr. Agatha van der Klaauw, PhD Wellcome Trust Postdoctoral Clinical Fellow Wellcome Trust-MRC Institute of Metabolic Science University of Cambridge Metabolic Research Laboratories Addenbrooke's Hospital Cambridge, United KingdomMedicalResearch.com Interview with:
Dr. Agatha van der Klaauw, PhD
Wellcome Trust Postdoctoral Clinical Fellow
Wellcome Trust-MRC Institute of Metabolic Science
University of Cambridge Metabolic Research Laboratories
Addenbrooke’s Hospital
Cambridge, United Kingdom

 

Medical Research: What are the main findings of the study?

Dr. van der Klaauw: Obesity occurs when we eat more calories than we burn which is often easy to do as many foods are highly palatable and high in calories. Highly palatable foods such as chocolate trigger signals in the brain that give a feeling of pleasure and reward (sometimes called cravings) which can contribute to overeating. These signals are processed in the reward centres in the brain, where sets of neurons release chemicals such as dopamine. However, very little is known about whether the reward centres of the brain work differently in some people who are overweight.

In this study, we were interested in studying overweight people who had a problem with the melanocortin 4 receptor (MC4R) gene. About 1% of obese people have a problem in this gene which contributes to weight gain from a young age. We compared three groups of people: people who were overweight due to a problem in the MC4R gene, people who were overweight but the gene was normal and some people who were normal weight. We performed functional Magnetic Resonance Imaging (fMRI) scans to look at how the reward centres in the brain were activated by pictures of appetizing food such as chocolate cake compared to bland food such as rice or broccoli and non-food items such as staplers.

We found that in normal weight people, the reward centres are activated (light up) when they are shown pictures of cake or chocolate and the same was seen in overweight people with a problem in the MC4R gene. But we found that the reward centres were underactive in overweight volunteers (in whom the gene was normal).

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Child–Parent Resemblance in Body Weight Weaker in Minorities

Qi Zhang, Ph.D. Associate Professor School of Community and Environmental Health Old Dominion University, Norfolk, VA MedicalResearch.com Interview with:
Qi Zhang, Ph.D.
Associate Professor
School of Community and Environmental Health
Old Dominion University, Norfolk, VA


Medical Research: What are the main findings of the study?

Dr. Zhang: This study found the child-parent resemblance in body weight status varied by socio-demographics in the U.S. In short, the resemblance in BMI is weaker in minorities, older children and lower socioeconomic groups.
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Diabetes, Age and Obesity Drive Demand for Endocrinologists

Robert A. Vigersky, MD Walter Reed National Military Medical Center Bethesda, MDMedicalResearch.com Interview with:
Robert A. Vigersky, MD
Walter Reed National Military Medical Center
Bethesda, MD

Medical Research: What type of patients do endocrinologists typically treat and why is the demand for their services anticipated to grow?

Dr. Vigersky: Endocrinologists are physicians trained in managing, diagnosing, and treating disorders of the endocrine system:  thyroid, parathyroid, adrenal glands, hypophyseal and hypothalamic axes, ovaries, testes, and pancreas.  Their role involves controlling diabetes mellitus, menopause, hyperthyroidism and other conditions involving metabolism.

A major factor affecting the anticipated demand for health care services is the aging population.  In 2010, there were 37.5 million people age 65 or over, constituting about 12.7 percent of the total population, and by 2025 the population age 65 or over will number 62.5 million (17.9 percent of the population).  Due to the greater prevalence of many of the diseases in older age groups, like osteoporosis, diabetes, obesity, and thyroid nodules, the growth in the population age 65 or over will exert a major influence on the demand for endocrine services.

Diabetes, by itself, is a major driver of demand.  The incidence of Type 2 diabetes rises dramatically with age, and with obesity.  In an increasingly overweight population an estimated 22.3 million people in the U.S. are diagnosed with diabetes as of 2012, representing about 7 percent of the population. This estimate is higher than but consistent with those published by the CDC for 2010.  The percentage of the population with diagnosed diabetes continues to rise, with one study projecting that as many as one in three U.S. adults could have diabetes by 2050 if current trends continue.
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How Does Thyroid Disease Affect Ability To Work?

Mette Andersen Nexø Psychologist, Ph.D. student at The National Research Center for the Working Environment Copenhagen Area, DenmarkMedicalResearch.com: Interview with
Mette Andersen Nexø
Psychologist, Ph.D. student at The National Research Center for the Working Environment
Copenhagen Area, Denmark


MedicalResearch: What is the background for this study?

Answer: The present study is a systematic assessment of the influence of a spectrum of thyroid diseases on ability to work. By presenting new information on the possible socioeconomic consequences of thyroid diseases, the results can help bring awareness to important needs for rehabilitation of thyroid patients.
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Diabetes: Metformin Effectiveness in African Americans May Be Greater Than In Whites

L. Keoki Williams, MD, MPH Center for Health Policy and Health Services Research Department of Internal Medicine Henry Ford Health System Detroit, Michigan 48104MedicalResearch.com Interview with
L. Keoki Williams, MD, MPH
Center for Health Policy and Health Services Research
Department of Internal Medicine
Henry Ford Health System
Detroit, Michigan 48104

MedicalResearch: What are the main findings of the study?

Dr. Williams: Metformin is recommended as first line treatment for type 2 diabetes, and these recommendations are based on the results of clinical trials performed almost exclusively in white individuals.  This is the first study to specifically assess whether metformin is effective at reducing blood glucose levels in African American individuals.  In our large study of over 19,000 individuals, we showed that metformin was consistently more effective at reducing glycated hemoglobin (HbA1c) levels (a measure of long-term blood glucose control) in African Americans when compared with white individuals.

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PCOS: Inflammatory Markers May Signal Increase Risk of Pregnancy Complications

Prof. Stefano Palomba Department of Obstetrics and Gynecology University “Magna Graecia” of Catanzaro Catanzaro, ItalyMedicalResearch.com Interview with:
Prof. Stefano Palomba
Department of Obstetrics and Gynecology
University “Magna Graecia” of Catanzaro
Catanzaro, Italy

MedicalResearch: What are the main findings of the study?

Prof. Palomba: Our study demonstrates that simple markers of inflammation, commonly detectable in clinical practice with commercial kits, are significantly modified in women with PCOS during pregnancy and associated at an increased risk of complications during pregnancy in the same population with PCOS.
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Moderate Physical Activity May Decrease Heart Disease Risk in Perimenopausal Women

Unab I. Khan, M.B.,B.S., M.S.            Assistant Professor of Pediatrics and Family & Social Medicine Division of Adolescent Medicine The Children’s Hospital at Montefiore The Pediatric Hospital for Albert Einstein College of Medicine Bronx, NY 10467MedicalResearch.com Interview with:
Unab I. Khan, M.B.,B.S., M.S.  
Assistant Professor of Pediatrics and Family & Social Medicine
Division of Adolescent Medicine
The Children’s Hospital at Montefiore
The Pediatric Hospital for Albert Einstein College of Medicine
Bronx, NY 10467


MedicalResearch: What are the main findings of the study?

Dr. Khan: We wanted to find factors that lead to either an increase or decrease in risk of developing cardiovascular disease. We found that in middle aged overweight and obese women, who may not have any medical problems like diabetes, high blood pressure, high cholesterol, an increase in weight over time and the development of any of the conditions stated above, increased the risk of cardiovascular disease significantly.

On the other hand, even moderate physical activity decreased the risk of heart disease, even in the presence of the above stated conditions.
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Vitamin D Linked to Better Outcomes in Several Types of Cancer

Hui Wang, M.D., Ph.D., Professor Principal Investigator Director, Food Safety Research Center Institute for Nutritional Sciences, SIBS, CASMedicalResearch.com Interview with:
Hui Wang, M.D., Ph.D., Professor
Principal Investigator
Director, Food Safety Research Center
Institute for Nutritional Sciences, SIBS, CAS


MedicalResearch.com: What are the main findings of the study?


Dr. Wang: 
This meta-analysis has systematically reviewed 25 relevant studies composed of 17,332 cancer cases to give a comprehensive perspective on the relationship between vitamin D and cancer patient outcomes. Our result demonstrated that vitamin D levels are linked to better outcomes in several types of cancer patients. The strongest link was found in breast cancer, lymphoma and colorectal cancer. There was less evidence of a connection in people with lung cancer, gastric cancer, prostate cancer, leukemia, melanoma or Merkel cell carcinoma, but the available data were positive. We also found that a 10 nmol/L increase in vitamin D levels was tied to a 4 percent increase in survival among people with cancer.

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PCOS: Metformin and Weight Loss

Dr. Dorte Glintborg PhD Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University HospitalMedicalResearch.com Interview with:
Dr. Dorte Glintborg PhD
Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University Hospital

MedicalResearch.com: What are the main findings of this study?

Dr. Glintborg: The main finding of the study is that one year’s metformin treatment is associated with a minor but significant weight loss in patients with PCOS irrespective of BMI at study inclusion. Treatment with oral contraceptives improves sex-hormone levels but is associated with at minor weight gain. Based on the study results, clinicians should consider the combined treatment with metformin and oral contraceptives in patients with PCOS.

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Severe Obesity Linked to Vitamin D Deficiency

MedicalResearch.com Interview with:
Tomás Ahern MB, BCh, BAO
St Columcille’s Hospital and St Vincent’s University Hospital
Dublin, Ireland

MedicalResearch.com: What are the main findings of the study?

Answer: More than 40% of severely obese people, who make up 6.5% of American adults, are at risk of vitamin D deficiency.

Severely obese people with low vitamin D levels are less active and have worse physical function than those with healthy vitamin D levels. Other investigators have found that poor physical function predicts premature death – whether this is the case in people with severe obesity remains to be determined.

MedicalResearch.com: Were any of the findings unexpected?

Answer: Yes. Other studies, of people without severe obesity, have shown that people with low vitamin D levels have higher blood sugar levels and are more likely to have diabetes. We did not find such a relationship in this study of people with severe obesity.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: Determining serum 25-hydroxyvitamin D levels in severely obese people is appropriate because low levels are common and associated with poor physical activity and poor physical function.

The finding of a low 25-hydroxyvitamin D level should be a portal to interventions that improve physical function and should lead to consideration of vitamin D supplementation. Vitamin D supplementation can take the form of spending more time outdoors or chewing calcium and vitamin D tablets daily.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ahern: We feel that this study generates the imperative to determine the effects of vitamin D supplementation in severely obese people at risk of vitamin D deficiency. We feel it likely that vitamin D supplementation in this group will result in improvement in physical function and possibly improvement in other markers of increased mortality.

Citation:

Association between Vitamin D Status and Physical Function in the Severely Obese

T. Ahern, A. Khattak, E. O’Malley, C. Dunlevy, M. Kilbane, C. Woods, M. J. McKenna, D. O’Shea. Association Between Vitamin D Status and Physical Function in the Severely Obese. The Journal of Clinical Endocrinology & Metabolism, 2014; jc.2014-1704 DOI: 10.1210/jc.2014-1704

 

Obstructive Sleep Apnea Raises Risk of Osteoporosis

Kai-Jen Tien, MD Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center Assistant Professor, Center of General Education Chia Nan University of Pharmacy and Science Tainan, TaiwanMedicalResearch.com Interview with:
Kai-Jen Tien, MD
Division of Endocrinology and Metabolism,
Department of Internal Medicine,  Chi Mei Medical Center
Assistant Professor, Center of General Education
Chia Nan University of Pharmacy and Science
Tainan, Taiwan

MedicalResearch.com: What are the main findings of the study?

Answer:  We conducted the first and largest population-based cohort study to evaluate the association of obstructive sleep apnea (OSA) and osteoporosis in a 6-year follow-up investigation of an Asian population. OSA is characterized by repetitive episodes of apnea/hypopnea and hypoxia in tissue, which might impact the bone metabolism. The results of the study showed that patients with obstructive sleep apnea had 2.74 times the risk of osteoporosis than patents without obstructive sleep apnea after adjustment for the patient`s characteristics and comorbidities. Across all age groups and sex groups, individuals with OSA had higher incidence rate of osteoporosis than individuals without obstructive sleep apnea. Subgroup analysis showed that older patients and female patients had a higher risk for osteoporosis than their younger and male counterparts.
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Testosterone Levels: Middle Range Better for Older Men

Dr Bu Beng Yeap   MBBS, FRACP, PhD Professor, School of Medicine and Pharmacology, University of Western Australia Endocrinologist, Department of Endocrinology and Diabetes, Fremantle Hospital. School of Medicine and Pharmacology
Level 2, T Block, Fremantle Hospital, Alma Street, Fremantle, Western Australia 6160, AustraliaMedicalResearch.com Interview with:
Dr Bu Beng Yeap   MBBS, FRACP, PhD
Professor, School of Medicine and Pharmacology, University of Western Australia
Endocrinologist, Department of Endocrinology and Diabetes, Fremantle Hospital.

MedicalResearch.com: What are the main findings of the study?

Answer: We found that older men with testosterone levels in the middle of the range had the lowest mortality risk. Having a low testosterone level predicted higher mortality, and there was no benefit of having a high-normal testosterone level. Men with optimal rather than high testosterone levels lived longest.

The other important finding was that men with higher dihydrotestosterone levels had lower mortality from ischaemic heart disease, suggesting that androgens may protect against heart disease in older men.
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Metabolically healthy obese still at increased risk of diabetes, heart disease

Carlos Lorenzo, MD Department of Medicine, University of Texas Health Science Center 7703 Floyd Curl Drive San Antonio, Texas 78229MedicalResearch.com Interview with:
Carlos Lorenzo, MD
Department of Medicine, University of Texas Health Science Center
7703 Floyd Curl Drive
San Antonio, Texas 78229


MedicalResearch.com: What are the main findings of the study?

Dr. Lorenzo: Metabolically healthy obese individuals are at increased risk of developing of diabetes and cardiovascular disease. These findings were demonstrated in men and women and in Mexican Americans and non-Hispanic whites.

Management of excess weight and any metabolic abnormality appears to be important for all individuals.

Our study is also in agreement with previous studies that indicate that metabolically unhealthy normal weight individuals are at increased risk of developing of diabetes and cardiovascular disease.
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Thyroid Disease: Mortality in Elderly Hospitalized Patients

Pedro Iglesias, MD Department of Endocrinology and Nutrition Hospital Ramón y Cajal, Madrid SpainMedicalResearch.com Interview with:
Pedro Iglesias, MD
Department of Endocrinology and Nutrition
Hospital Ramón y Cajal, Madrid Spain

MedicalResearch.com What are the main findings of the study?

Dr. Iglesias: The main findings of our study are that alterations in TFT results are related to mortality in aged patients hospitalized for acute illness not only during hospitalization but also long term after discharge. Low FT3, low FT4, and low TSH serum concentrations are associated with decrease survival time, although only low FT3 behaves as a significant predictor of all-cause and CV mortality.

MedicalResearch.com Were any of the findings unexpected?

Dr. Iglesias: The most unexpected finding of our study was that low serum free T3 level behaves as a prognostic marker of mortality not only in the short term but also in the long term.

MedicalResearch.com What should clinicians and patients take away from your report?

Dr. Iglesias: We have a reliable marker of all-cause and cardiovascular mortality in the short and long term in elderly hospitalized patients for acute disease, and this marker is T3.

MedicalResearch.com What recommendations do you have for future research as a result of this study?

Dr. Iglesias: It would be interesting to know the behaviour of serum T3 levels according to different clinical variables such as used treatments, clinical complications over time, and new therapies among others.

Citation:

Thyroid Function Tests and Mortality in Aged Hospitalized Patients: A 7-Year Prospective Observational Study.

Iglesias P, Ridruejo E, Muñoz A, Prado F, Macías MC, Guerrero MT, Tajada P, García-Arévalo C, Díez JJ.

Department of Endocrinology (P.I., J.J.D.), Hospital Ramón y Cajal, 28034 Madrid, Spain; and Departments of Geriatrics (E.R., A.M., F.P., M.C.M., M.T.G.) and Biochemistry (P.T., C.G.-A.), Hospital General, 28007 Segovia, Spain.

J Clin Endocrinol Metab. 2013 Oct 30. [Epub ahead of print]

 

 

PCOS – Polycystic Ovary Syndrome: Should it be Renamed?

Professor Helena Teede MBBS, PhD, FRACP Director Monash Centre for Health Research and Implementation -- MCHRI, And Head Womens Public Health Research, School Public Health and Preventive Medicine Monash University, in partnership with Monash Health Head Diabetes and Vascular Medicine, Monash Health President Elect- Endocrine Society of Australia NHMRC Practitioner Fellow 43-51 Kanooka Grove, Clayton, Victoria 3168 AustraliaMedicalResearch.com Interview with:
Professor Helena Teede MBBS, PhD, FRACP
Director Monash Centre for Health Research and Implementation — MCHRI,
And Head Womens Public Health Research, School Public Health and Preventive Medicine Monash University, in partnership with Monash Health
Head Diabetes and Vascular Medicine, Monash Health
President Elect- Endocrine Society of Australia
NHMRC Practitioner Fellow
43-51 Kanooka Grove, Clayton, Victoria 3168 Australia

MedicalResearch.com: What are the main findings of the study?

Dr. Teede: PCOS is a historical but histopathologically inaccurate name for a common condition that is a source of confusion for women and primary health care providers.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Teede: The unexpected findings were that many women and primary care providers do not have a good understanding of the features of PCOS outside of reproductive features. These include the metabolic (diabetes risk) and psychological factors in PCOS.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Teede: An awareness that the condition is inappropriately named and that it is caused by hormonal changes which underpin PCOS and cause metabolic and reproductive features including secondary functional ovary changes.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Teede: Further research needs to explore other suitable names for the syndrome and needs to assess the results of new guidelines and education programs to improve consumer and clinician understanding of PCOS.

Citation:

Helena Teede, Melanie Gibson-Helm, Robert J. Norman, and Jacqueline Boyle

Polycystic Ovary Syndrome: Perceptions and Attitudes of Women and Primary Health Care Physicians on Features of PCOS and Renaming the Syndrome JCEM jc.2013-2978; doi:10.1210/jc.2013-2978

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Obesity: Inflammatory Markers May Detect Risk of Diabetes, Heart Disease

MedialResearch.com Interview with:
Dr Catherine M. Phillips
Health Research Board Centre for Diet and Health Research
Room 4.033, Department of Epidemiology and Public Health
Western Gateway Building, University College Cork, Cork, Ireland

MedialResearch.com: What are the main findings of the study?

Answer: Obesity is associated with increased risk of diabetes and heart disease leading to reduced life expectancy. However in recent years it has been recognized that not all obese individuals are at increased risk – these individuals have been described as being metabolically healthy obese (MHO) in that despite carrying excess weight they do not have the typical abnormal metabolic features associated with obesity such as hypertension, insulin resistance and alterations to their lipid profile.

It is not clear what factors determine whether an obese person becomes metabolically healthy or unhealthy. In this study conducted at the Dept. of Epidemiology and Public Health at University College Cork, Ireland, we examined levels of a range of inflammatory markers in 2047 middle-aged Irish adults to investigate to what extent differences between metabolically healthy and unhealthy obese and non-obese male and female adults are explained by inflammatory status. Participants, who were between the ages of 50 and 69, completed lifestyle questionnaires, physical and clinical assessments, and underwent blood testing so their body mass index (BMI), metabolic profiles and inflammatory markers could be determined. We found that, regardless of a person’s BMI, having a favorable inflammatory profile was associated with being metabolically healthy. Specifically metabolically healthy individuals presented with lower levels of complement component 3, C reactive protein, tumour necrosis factor alpha, interleukin 6, plasminogen activator inhibitor-1, reduced white blood cell count and higher adiponectin levels compared to their metabolically unhealthy counterparts.
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