1. Weight at Birth Tied to Heart Disease and Diabetes Risk in Adulthood
2. Balancing Hormones May Help Prevent Preterm Births
3. Endocrine Society Releases New Clinical Practice Guideline on Adult Hypoglycemic Disorders
4. News Media Registration Open for ENDO 09 in Washington, D.C.
5. New Patient Guide on the Diagnosis and Management of Hypoglycemic Disorders in Adults Available
1. Weight at Birth Tied to Heart Disease and Diabetes Risk in Adulthood
Lower weight at birth may increase inflammatory processes in adulthood, which are associated with chronic diseases such as heart disease and diabetes, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Both the fetal and infancy periods are sensitive, critical stages of growth and development. Studies have previously suggested babies with lower weight at birth are at a higher risk for developing chronic diseases but until now, there has been little understanding to explain why. This study suggests an association between lower weight at birth and inflammation in adulthood may provide that explanation.
Inflammation is a normal physiologic response of the body, and serves as a host defense which provides protective response to infection or tissue injury. If the source of infection or injury is not repressed, low-grade inflammation can persist and may promote the development of heart disease or diabetes.
Earlier studies have found that babies born small for gestational age have weak immune systems, but at six years old have more white blood cells than babies born at a normal weight. White blood cells are cells of the immune system that defend the body against both infectious disease and foreign materials. These findings suggest that age might amplify the association between early growth and inflammatory processes.
In this study, researchers followed 5,619 children born in 1966 and followed them up until they reached adulthood. As compared to children with ‘normal’ weight in the first year of life, researchers observed that babies born relatively smaller and gained the least weight during infancy had a higher number of white blood cells, an indicator of inflammation, in adulthood.
“Our findings suggest that the link between poorer growth early in life and these adult chronic diseases may involve inflammation as a common underlying factor,” said Dr. Dexter Canoy, MD, PhD, of the University of Manchester in the UK and lead researcher of the study. “Ensuring appropriate growth during this narrow ‘window’ in early development may confer lifelong benefits to health.”
Other researchers working on the study include Anneli Pouta, Aimo Ruokonen, Anna-Liisa Hartikainen, Pekka Saikku and Marjo-Riitta Järvelin of the University of Oulu in Finland and Imperial College London in the UK.
The article “Weight at birth and infancy in relation to adult leukocyte count: a population-based study of 5,619 men and women followed from the fetal period to adulthood,” will appear in the June 2009 issue of JCEM.
2. Balancing Hormones May Help Prevent Preterm Births
The relationship between two different types of estrogen and a hormone produced in the placenta may serve as the mechanism for signaling labor, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). This finding may help doctors intervene and prevent preterm birth much more effectively.
“The trigger for the onset of labor in women has been a puzzle for a long time,” says Dr. Roger Smith, MD, PhD, of John Hunter Hospital in Newcastle, Australia and lead author of the study. “Our findings show we may have an answer, and furthermore may be able to delay or advance labor.”
Humans have two types of estrogen called estradiol (E2) and estriol (E3). When E2 and E3 are in roughly equal amounts there is no drive to labor, but the opposite holds true once one becomes in greater excess than the other. This study evaluated the ratio of E3 to E2 in 500 pregnant women and found that it went up rapidly as labor approached indicating that E3 could stimulate the onset of labor.
Dr. Smith and his colleagues then sought to understand what was causing the increase in E3 and they believe they found an answer. In a previous study they showed that a hormone in the placenta, called corticotrophin-releasing hormone (CRH), rises rapidly through pregnancy, peaking at the time of labor. CRH levels rise earlier in women who deliver prematurely and later in women who deliver late, forming a biological clock that regulates the length of pregnancy.
Researchers also showed that CRH can act on the adrenal glands of the fetus to stimulate the production of a steroid hormone which the placenta uses to make E3. This study showed a strong relationship between CRH levels in the mother’s blood in the weeks before birth and the levels of E3 supporting the view that CRH increases E3.
“CRH may be the catalyst for the onset of labor, by driving steroid hormone production in the fetus, which then leads to an increase in E3 so that it exceeds E2,” said Dr. Smith. “If this progression is correct, it may explain why women with a baby who dies in utero can still go into labor. In this scenario, levels of E3 would drop making E2 more dominant and triggering the onset of labor.”
“It may be possible to delay or advance labor by varying the ratio of E3 to E2 by giving either E2 or E3 to the pregnant woman,” said Dr. Smith. “It may also be possible to predict the timing of birth by monitoring this ratio between the two estrogens.”
Dr. Smith notes that this is the first study to show these results and confirmation through further research is needed.
Other researchers working on the study include Julia Smith, Patricia Engel, Maria Bowman, Andrew Bisits and Shaun McGrath of the Mothers and Babies Research Centre at the University of Newcastle in Australia; and Patrick McElduff of the Hunter Medical Research Institute in Newcastle, Australia; David Smith of the University of Western Australia; and Warwick Giles of the University of Sydney in Australia.
The article “Patterns of Plasma Corticotrophin-Releasing Hormone, Progesterone, Estradiol and Estriol Change and the Onset of Human Labor,” will appear in the June 2009 issue of JCEM.
3. Endocrine Society Releases New Clinical Practice Guideline on Adult Hypoglycemic Disorders
The Endocrine Society released a new clinical practice guideline for the evaluation and management of adult hypoglycemic disorders. The guideline appears in the March 2009 issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of The Endocrine Society.
A “hypoglycemic disorder” is a condition characterized by the effects of hypoglycemia, the medical term for low blood sugar (or blood glucose). Glucose is the “fuel” that the brain and body need to function properly. If hypoglycemia is not corrected right away, the condition can quickly worsen, and in severe cases, lead to loss of consciousness, seizure or coma.
“Prevention and treatment of hypoglycemia can be complex as symptoms and causes of the condition can vary from patient to patient, “ said Philip Cryer, MD, of Washington University School of Medicine in St. Louis, Mo. and chair of the task force that developed the guideline. “This new clinical guideline offers recommendations to doctors about how best to confirm that an adult patient has a hypoglycemic disorder, determine its cause and prevent its recurrence.”
According to medical experts, a hypoglycemic disorder can’t be diagnosed with confidence simply on the basis of low blood sugar, therefore the clinical guideline recommends that doctors use three criteria often referred to as “Whipple’s triad” to diagnose a hypoglycemic disorder. The three components of Whipple’s triad include: signs and symptoms of hypoglycemia; low blood sugar measured by a reliable chemical test; and disappearance of signs and symptoms after the blood sugar level is raised.
Hypoglycemia is common in people with diabetes but rare in people who do not have diabetes. The guideline recommends different treatment strategies for each group.
The guideline can be viewed online at: The Journal of Clinical Endocrinology & Metabolism Vol. 94, No. 3 709-728
Other members of the task force that developed this guideline included Lloyd Axelrod of Harvard Medical School in Boston, Mass.; Ashley Grossman of Queen Mary University of London in U.K.; Simon Heller of the University of Sheffield in U.K.; Elizabeth Seaquist of the University of Minnesota in Minneapolis; and Victor Montori and F. John Service of the Mayo Clinic in Rochester, Minn.
4. News Media Registration Open for ENDO 09 in Washington, D.C.
The Endocrine Society's 91st Annual Meeting, ENDO 09 will be held at the Walter E Washington Convention Center in Washington, DC, June 10-13, 2009. Approximately 7,500 scientists and clinicians from all over the world are expected to assemble for this premier meeting of hormone research, health science, and endocrinology.
It is an opportunity for journalists to learn about the latest research in fields as diverse as anabolic steroids, obesity, endocrine disrupters, diabetes, aging, growth hormone, sex hormones, thyroid cancer, and much more.
For public information officers, ENDO provides a worldwide stage to promote your institution's research to reporters through press releases and participation by your scientists in press conferences.
Reporter Eligibility
• Working press employed by bona fide news media: must present a press card, business card, or letter of introduction from an editor of a recognized publication.
• Freelance writers: must present a current members card from the American Medical Writers Association or the National Association of Science Writers; evidence of by-lined work pertaining to science, health, medicine, or biomedical research intended for the general public and published within the past two years; or a letter of assignment from a recognized publication.
• Public information officers of scientific societies, medical associations, educational institutions, and government agencies: must present a business card.
• Representatives of for-profit corporations and of the business side of news media must register onsite, pay the appropriate fees, and are not accredited as Press at the meeting.
• Researchers and clinicians who are also reporters and who are presenting at this meeting (oral or poster session) may receive news media credentials if they qualify (see above), but must also register for the meeting and pay the appropriate fee as a presenter.
A full program, including press conferences and media activities, will be distributed as information becomes available. Registered news media receive a badge that provides access to all meeting sessions, as well as to the News Room and press conferences. No one will be admitted without a valid ENDO badge.
The News Media Registration Form and information are available online at http://www.endo-society.org/endo/media.cfm
5. New Patient Guide on the Diagnosis and Management of Hypoglycemic Disorders in Adults Available
The Hormone Foundation recently published a patient guide that defines a hypoglycemic disorder, identifies signs and symptoms, and explains its causes in adults with and without diabetes. Preventing a recurrence and partnering with one’s physician are also covered. The patient guide is based on The Endocrine Society’s clinical guidelines on the evaluation and management of adult hypoglycemic disorders. To view the guide, visit http://www.hormone.org/Resources/upload/patient-guide-diagnosis-and-management-hypoglycemia-022509.pdf
