Pub Date : 2020-07-15DOI: 10.29245/2767-5157/2020/1.1109
D. Khan, R. C. Moffett
Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with infertility which affects one in ten women in the United Kingdom. Women with PCOS are typified by insulin resistance, gestational diabetes and obesity. Therefore, a close association between reproductive function and nutrition is postulated. However, regulatory pathways common to energy and reproductive function have received little attention. Recent research shows rapid amelioration of infertility, PCOS and type 2 diabetes following Roux-en-Y bariatric surgery (RYGB). This occurs prior to weight loss suggesting involvement of gut derived factors. Therefore, gut hormones emerge as key players in the regulation of both energy homeostasis and possibly reproductive function. Alteration of gut peptide levels including GLP-1, GIP, PYY, ghrelin, NPY and neurotensin post-bariatric surgery suggest a plausible mechanism behind beneficial effects of RYGB. Furthermore, expression of gut peptide receptors within the reproductive axis strengthen the idea of involvement of these hormones in the remission of fertility post-surgery. The present commentary discusses the role of these important gut peptides and their receptors in the regulation of female reproductive system in the light of a recent article published by our laboratory. Understanding the functional relationship between the gut and reproductive axis will help us to identify novel and less invasive alternatives to bariatric surgeries for reproductive and related metabolic disorders.
{"title":"Commentary: Emerging role of GIP and related gut hormones in fertility and PCOS","authors":"D. Khan, R. C. Moffett","doi":"10.29245/2767-5157/2020/1.1109","DOIUrl":"https://doi.org/10.29245/2767-5157/2020/1.1109","url":null,"abstract":"Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with infertility which affects one in ten women in the United Kingdom. Women with PCOS are typified by insulin resistance, gestational diabetes and obesity. Therefore, a close association between reproductive function and nutrition is postulated. However, regulatory pathways common to energy and reproductive function have received little attention. Recent research shows rapid amelioration of infertility, PCOS and type 2 diabetes following Roux-en-Y bariatric surgery (RYGB). This occurs prior to weight loss suggesting involvement of gut derived factors. Therefore, gut hormones emerge as key players in the regulation of both energy homeostasis and possibly reproductive function. Alteration of gut peptide levels including GLP-1, GIP, PYY, ghrelin, NPY and neurotensin post-bariatric surgery suggest a plausible mechanism behind beneficial effects of RYGB. Furthermore, expression of gut peptide receptors within the reproductive axis strengthen the idea of involvement of these hormones in the remission of fertility post-surgery. The present commentary discusses the role of these important gut peptides and their receptors in the regulation of female reproductive system in the light of a recent article published by our laboratory. Understanding the functional relationship between the gut and reproductive axis will help us to identify novel and less invasive alternatives to bariatric surgeries for reproductive and related metabolic disorders.","PeriodicalId":93655,"journal":{"name":"Journal of endocrinological science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43190599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-27DOI: 10.29245/2767-5157/2020/1.1108
A. L. Buglio, F. Bellanti, G. Vendemiale
Malnutrition is associated to poor clinical outcomes, especially in hospitalized patients. High prevalence of low-grade chronic inflammation, low skeletal muscle mass, and insulin resistance are often found in malnourished patients. Increasing evidence shows how these effects can be partially reverted through an adequate intake of food or using specific dietary supplementation. In this scenario, Mediterranean Diet (MD) demonstrated positive effects on the nutritional status, with important clinical finding in hospitalized patients such as low rate of length of stay and in-hospital mortality. The aim of this review is the summary of the main evidence about the role of Mediterranean diet on health and clinical outcomes in hospitalized elderly patients.
{"title":"Adherence to Mediterranean Diet and Nutritional Status: Impact on Clinical Outcomes in Hospitalized Elderly Patients","authors":"A. L. Buglio, F. Bellanti, G. Vendemiale","doi":"10.29245/2767-5157/2020/1.1108","DOIUrl":"https://doi.org/10.29245/2767-5157/2020/1.1108","url":null,"abstract":"Malnutrition is associated to poor clinical outcomes, especially in hospitalized patients. High prevalence of low-grade chronic inflammation, low skeletal muscle mass, and insulin resistance are often found in malnourished patients. Increasing evidence shows how these effects can be partially reverted through an adequate intake of food or using specific dietary supplementation. In this scenario, Mediterranean Diet (MD) demonstrated positive effects on the nutritional status, with important clinical finding in hospitalized patients such as low rate of length of stay and in-hospital mortality. The aim of this review is the summary of the main evidence about the role of Mediterranean diet on health and clinical outcomes in hospitalized elderly patients.","PeriodicalId":93655,"journal":{"name":"Journal of endocrinological science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48029039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.29245/2767-5157/2020/1.1106
S. Ramakrishnan, Mohammed Yousuf Khan, Anantharaman Ramakrishnan, Shanmugasundar Gopal, Rohit S. Warrier
Psoriasis is an immune mediated chronic skin disease associated with components of metabolic syndrome like obesity and type-2 diabetes. Previously, anti-diabetic drugs especially insulin sensitizers (metformin and pioglitazone) have shown positive outcomes in subjects with psoriasis1. Recently, many case series and longitudinal observational studies previously have demonstrated improvement in psoriasis with GLP1 agonist therapy when followed up for 8-12 weeks2,3. We report a patient with psoriasis and Type2 DM in whom a marked improvement in psoriasis was seen with liraglutide therapy, even with a short course of therapy for 4 weeks, which has not been previously recorded, to the best of our knowledge. This could be due to our subject possibly being a better GLP-1 responder based on baseline characteristics of relatively higher BMI and HbA1c4.
{"title":"Remarkable Improvement in Plaque Psoriasis with a 4 week Short Course Liraglutide Therapy in an Obese Type 2 DM Patient","authors":"S. Ramakrishnan, Mohammed Yousuf Khan, Anantharaman Ramakrishnan, Shanmugasundar Gopal, Rohit S. Warrier","doi":"10.29245/2767-5157/2020/1.1106","DOIUrl":"https://doi.org/10.29245/2767-5157/2020/1.1106","url":null,"abstract":"Psoriasis is an immune mediated chronic skin disease associated with components of metabolic syndrome like obesity and type-2 diabetes. Previously, anti-diabetic drugs especially insulin sensitizers (metformin and pioglitazone) have shown positive outcomes in subjects with psoriasis1. Recently, many case series and longitudinal observational studies previously have demonstrated improvement in psoriasis with GLP1 agonist therapy when followed up for 8-12 weeks2,3. We report a patient with psoriasis and Type2 DM in whom a marked improvement in psoriasis was seen with liraglutide therapy, even with a short course of therapy for 4 weeks, which has not been previously recorded, to the best of our knowledge. This could be due to our subject possibly being a better GLP-1 responder based on baseline characteristics of relatively higher BMI and HbA1c4.","PeriodicalId":93655,"journal":{"name":"Journal of endocrinological science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41812240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-29DOI: 10.29245/2767-5157/2020/1.1110
Catherine E. Kerr, Sarah D. Hackman, Gary L. Francis
Thyroid nodules (TN) and differentiated thyroid cancers (DTC) are reported in increasing numbers of children and adolescents. In part, this results from increased use of thyroid ultrasound (US) surveillance and diagnosis using fine needle aspiration (FNA)1. However, large TN and DTC are also increasingly common, suggesting a true rise in incidence2. Several factors increase the risk for TN, including genetic syndromes, radiation exposure, iodine deficiency, autoimmune thyroid disease (AIT), and Graves’ disease (GD). This review will address recent advances in knowledge regarding TN prevalence, risk factors, differential diagnosis, evaluation, and management.
{"title":"Thyroid Nodules in Children and Adolescents: Mini-review","authors":"Catherine E. Kerr, Sarah D. Hackman, Gary L. Francis","doi":"10.29245/2767-5157/2020/1.1110","DOIUrl":"https://doi.org/10.29245/2767-5157/2020/1.1110","url":null,"abstract":"Thyroid nodules (TN) and differentiated thyroid cancers (DTC) are reported in increasing numbers of children and adolescents. In part, this results from increased use of thyroid ultrasound (US) surveillance and diagnosis using fine needle aspiration (FNA)1. However, large TN and DTC are also increasingly common, suggesting a true rise in incidence2. Several factors increase the risk for TN, including genetic syndromes, radiation exposure, iodine deficiency, autoimmune thyroid disease (AIT), and Graves’ disease (GD). This review will address recent advances in knowledge regarding TN prevalence, risk factors, differential diagnosis, evaluation, and management.","PeriodicalId":93655,"journal":{"name":"Journal of endocrinological science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47430946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-02DOI: 10.29245/2767-5157/2020/1.1104
S. Ramakrishnan, Anantharaman Ramakrishnan, Rohit S. Warrier, Shanmugasundar Gopal
We describe a case where we effectively managed chronic, uncontrolled type 2 diabetes with hydroxychloroquine (HCQS) as an add on therapy, wherein the patient was on multiple oral hypoglycemic agents along with a combination of injectable incretin/insulin therapy prior to HCQS initiation. Six months into combination therapy with HCQS, the target HbA1c was achieved for the first time in the patient’s recent history at a much lower daily insulin dose (56% requirement drop), which has never been documented before. This combination also resulted in significant weight loss. We make a case for advocating the use of HCQS to the available routine diabetes therapeutic agents, especially if the blood sugars fail to achieve target levels in spite of being on intensive management with insulin and for the obese phenotype.
{"title":"Hydroxychloroquine (HCQS) for glycaemic control: a remarkable turnaround in a patient with Type 2 DM","authors":"S. Ramakrishnan, Anantharaman Ramakrishnan, Rohit S. Warrier, Shanmugasundar Gopal","doi":"10.29245/2767-5157/2020/1.1104","DOIUrl":"https://doi.org/10.29245/2767-5157/2020/1.1104","url":null,"abstract":"We describe a case where we effectively managed chronic, uncontrolled type 2 diabetes with hydroxychloroquine (HCQS) as an add on therapy, wherein the patient was on multiple oral hypoglycemic agents along with a combination of injectable incretin/insulin therapy prior to HCQS initiation. Six months into combination therapy with HCQS, the target HbA1c was achieved for the first time in the patient’s recent history at a much lower daily insulin dose (56% requirement drop), which has never been documented before. This combination also resulted in significant weight loss. We make a case for advocating the use of HCQS to the available routine diabetes therapeutic agents, especially if the blood sugars fail to achieve target levels in spite of being on intensive management with insulin and for the obese phenotype.","PeriodicalId":93655,"journal":{"name":"Journal of endocrinological science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43458516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.29245/2767-5157/2019/1.1103
P. Lissoni
Several clinical studies have shown that blood pressure (BP) declines during the night in the healthy subjects, and that BP circadian rhythm tends to disappear with age. The mechanisms responsible for BP circadian rhythm and its aging-dependent loss need to be further understood. At present, it is already known that the two main hormones provided by hypotensive activity, consisting of the cardiac hormone atrial natriuretic peptide (ANP) and the pineal indole hormone melatonin (MLT), are mainly produced during the night, whereas hypertensive hormones, such as cortisol, are mainly produced during the early period of light phase. Then, the circadian variations of BP would be the consequence of changes in the neuroendocrine system. On this basis, a preliminary study was performed to establish which relation may exist among BP, ANP and MLT rhythms in the healthy subjects. The study included 20 65-year younger, and 20 65-year older healthy subjects. In 65-year younger subjects, both systolic and diastolic BP mean values significantly decreased during the night, whereas no significant difference occurred in the 65-older ones, because of BP values decreased in the night only in 13/20 (65) subjects. In addition, within the 65-year older group, both ANP and MLT night mean values were significantly higher in subjects with BP rhythm than in those, who had no BP daily variations. These preliminary results would suggest that age-dependent loss in the circadian rhythm of BP may be caused by the concomitant loss in the circadian secretion of at least two major hypotensive hormones, such as ANP and MLT.
{"title":"A Study of Blood Pressure in Relation to the Light/Dark Variations of the Cardiac Hormone Atrial Natriuretic Peptide and the Pineal Hormone Melatonin in Adult and Old Population","authors":"P. Lissoni","doi":"10.29245/2767-5157/2019/1.1103","DOIUrl":"https://doi.org/10.29245/2767-5157/2019/1.1103","url":null,"abstract":"Several clinical studies have shown that blood pressure (BP) declines during the night in the healthy subjects, and that BP circadian rhythm tends to disappear with age. The mechanisms responsible for BP circadian rhythm and its aging-dependent loss need to be further understood. At present, it is already known that the two main hormones provided by hypotensive activity, consisting of the cardiac hormone atrial natriuretic peptide (ANP) and the pineal indole hormone melatonin (MLT), are mainly produced during the night, whereas hypertensive hormones, such as cortisol, are mainly produced during the early period of light phase. Then, the circadian variations of BP would be the consequence of changes in the neuroendocrine system. On this basis, a preliminary study was performed to establish which relation may exist among BP, ANP and MLT rhythms in the healthy subjects. The study included 20 65-year younger, and 20 65-year older healthy subjects. In 65-year younger subjects, both systolic and diastolic BP mean values significantly decreased during the night, whereas no significant difference occurred in the 65-older ones, because of BP values decreased in the night only in 13/20 (65) subjects. In addition, within the 65-year older group, both ANP and MLT night mean values were significantly higher in subjects with BP rhythm than in those, who had no BP daily variations. These preliminary results would suggest that age-dependent loss in the circadian rhythm of BP may be caused by the concomitant loss in the circadian secretion of at least two major hypotensive hormones, such as ANP and MLT.","PeriodicalId":93655,"journal":{"name":"Journal of endocrinological science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45526524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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