Category Archives: Endocrinology

Endocrinology

TikTok Offers to ‘Balance Your Hormones’ Are Pure Hokum – Medscape

With more than 306 million views, #hormonebalance and #hormonebalancing are among the latest hacks to take over the social media platform TikTok, on which users post short videos. Influencers offer advice such as eating raw carrots for "happy hormones," eating protein followed by fat for breakfast to regulate blood glucose, or taking vitamin B2 supplements for thyroid health.

Raymond de la Rosa, MD

Have you ever wondered if you were asleep during the lecture on "hormone balancing" in medical school? No, you weren't. It was never a class for good reason, and you didn't fail to read any such breakthrough studies in The New England Journal of Medicine either.

Although the soundbites no doubt garner attention among TikTok users, "hormone balancing" is a fictional term that is practically meaningless.

There are over 50 different hormones produced by humans and animals, regulating sleep, growth, metabolism and reproduction, among many other biological processes, so there is certainly no one-size-fits-all solution to ensure these are all working in perfect harmony.

When someone mentions "hormone balancing," my mind wanders to the last time I took my car to have my tires rotated and balanced. If only it were as simple to balance hormones in real life. The best we can hope for is to get a specific hormone within the ideal physiologic range for that person's age.

The term "hormone" can mean many things to different people. When a woman comes in with a hormone question, for example, it is often related to estrogen, followed by thyroid hormones. A wealth of misinformation exists in popular literature regarding these hormones alone.

Estrogen can be replaced, but not everyone needs it replaced. It depends on variables including age, underlying medical conditions, the time of day a test was drawn, and concomitant medications. Having low levels of a given hormone does not necessarily call for replacement either.

Insulin is another example of a hormone that can never completely be replaced in people with diabetes in a way that exactly mimics the normal physiologic release.

There are many lesser-known hormones that are measurable and replaceable but are also more difficult to reset to original manufacturer specifications.

A Google search for "hormone balancing" often sends you to "naturopaths" or "integrative medicine" practitioners, who often propose similar solutions to the TikTok influencers. Users are told that their hormones are out of whack and that restoring this "balance" can be achieved by purchasing whatever "natural products" or concoction they are selling.

These TikTok videos and online "experts" are the home-brewed versions of the strip-mall hormone specialists. TikTok videos claiming to help "balance hormones" typically don't name a specific hormone either, or the end-organs that each would have an impact on. Rather, they lump all hormones into a monolithic entity, implying that there is a single solution for all health problems. And personal testimonials extolling the benefits of a TikTok intervention don't constitute proof of efficacy no matter how many "likes" they get. These influencers assume that viewers can "sense" their hormones are out of tune and no lab tests can convince them otherwise.

In these inflationary times, the cost of seeking medical care from conventional channels is increasingly prohibitive. It's easy to understand the appeal of getting free advice from TikTok or some other internet site. At best, following the advice will not have much impact; at worst, it could be harmful.

There are some things that should never be tried at home, and do-it yourself hormone replacement or remediation both fall under this umbrella.

Generally, the body does a good job of balancing its own hormones. Most patients don't need to be worried if they're in good health. If they're in doubt, they should seek advice from a doctor, ideally an endocrinologist, but an ob/gyn or general practitioner are also good options.

One of the first questions to ask a patient is "Which hormone are you worried about?" or 'What health issue is it specifically that is bothering you?" Narrowing the focus to a single thing, if possible, will lead to a more efficient evaluation.

Often, patients arrive with multiple concerns written on little pieces of paper. These ubiquitous pieces of paper are the red flag for the flood of questions to follow.

Ordering the appropriate tests for the conditions they are concerned about can help put their minds at ease. If there are any specific deficiencies, or excesses in any hormones, then appropriate solutions can be discussed.

TikTok hormone balancing solutions are simply the 21st-century version of the snake oil sold on late-night cable TV in the 1990s.

Needless to say, you should gently encourage your patients to stay away from these nonFDA-approved products, without making them feel stupid. Off-label use of hormones when these are not indicated is also to be avoided, unless a medical practitioner feels it is warranted.

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TikTok Offers to 'Balance Your Hormones' Are Pure Hokum - Medscape

Endocrinology

More than 30,000 European and international endocrinologists urge Brussels to take action on REACH revision – Newswise

Newswise A broad coalition of over 30,000 European and international endocrine experts have today called on EU legislators to publish the revised REACH proposal without any further delay and no later than June 2023.

Citing the urgent and immediate need to minimise exposure to Endocrine Disrupting Chemicals (EDCs) in the interest of public health, the experts insist that flaws in the REACH regulation must be addressed without delay. EDCs are not a compromise area, and extending the current legislation is required to fulfill the mentioned objectives.

The petition was launched by the Endocrine Society, the European Society of Endocrinology (ESE), and 42 European national and specialist endocrine societies represent the European and international endocrine research and clinical community. The petition has been submitted to the European Commission.

The experts are extremely concerned that the current REACH regulation does not effectively address the numerous health impacts stemming from EDC exposure. The necessary steps to reduce exposure to hazardous EDCs and establish lasting protection for human health can only come in a revision of REACH itself.

EDCs are not an area for compromise. An immediate and rigorous revision and extension to the current legislation is needed to effectively address the many current adverse health impacts. Any further delay is unacceptable.

In addition to the huge impact on human and ecological health, EDCs are also linked to massive economic costs borne by EU citizens: conservative estimates have linked EDC exposures to some157 billion in additional health care costs and lost earnings.

EDCs, which include bisphenols, phthalates, and PFAS, among other chemicals in commerce, are pervasive and linked to serious adverse effects on endocrine systems leading to diseases such as infertility, diabetes, cancer, and altered neurological development. Health impacts from EDC exposures are widespread and cause suffering throughout the European Union. Moreover, individuals such as pregnant women and children are uniquely susceptible to the effects of endocrine disruption, meaning that action now can prevent harm to current and future generations.

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More than 30,000 European and international endocrinologists urge Brussels to take action on REACH revision - Newswise

Endocrinology

Over 1500 healthcare professionals attend 7th Qatar Diabetes … – The Peninsula

Delegates attend a session during the Seventh Qatar Diabetes, Endocrinology, and Metabolic Conference (QDEM-7).

Doha: More than 1500 healthcare professionals attended the Seventh Qatar Diabetes, Endocrinology, and Metabolic Conference (QDEM-7) which was hosted by Hamad Medical Corporations (HMC) Endocrine and Diabetes Division, Department of Medicine, and the Qatar Metabolic Institute (QMI).

The conference, held in person and online with attendees and speakers from around the world, brought together local and international experts in the fields of endocrinology, obesity, and diabetes to discuss the latest research, treatments, technological advances, and preventative measures for these conditions.

The event also incorporated the 2nd Qatar Diabetes and Obesity Research Symposium a flagship activity of the National Diabetes Strategy, 2016-2022, and intends to promote diabetes and obesity research in Qatar.

World-renowned international, regional and local speakers presented and updated delegates on a diverse range of topics including non-alcoholic fatty liver disease; Pediatric Endocrinology; Perimenopausal management; Neuroendocrine disorders and calcium and electrolytes disorders

Dr. Mahmoud Ali Zirie, Chair of the Conferences Organizing Committee and Head of HMCs Endocrinology and Diabetes Division, said the conference provided an opportunity to share the work being done here in Qatar and to deliver improvements tailored to the local population.

This year our program focused on a range of important and emerging areas including diabetes and obesity in pediatric patients and the latest technologies available, Dr. Zirie said. Its more important than ever that healthcare professionals have access to the most up-to-date research and information about diabetes, endocrinology and metabolic medicine.

Professor Abdul Badi Abou Samra, Director of Qatar Metabolic Institute, said the event provided an important platform for frontline clinicians, scientists, and researchers to discuss strategies and approaches for the management and prevention of diabetes and associated conditions.

Diabetes is a complex condition which can lead to debilitating long-term complications and acute illness. The disease in Qatar is quite prevalent with about 17 percent of Qatars adult population thought to have diabetes. About 20 percent of Qatars population is estimated to be pre-diabetic, he said.

Dr. Ibrahim Al Janahi, Chair of the Scientific Committee and Senior Consultant in Endocrine and Diabetes Division said many diabetics live with other associated complications such as high blood pressure, kidney disease, and vision impairment which require additional consideration.

It is important for the local and international medical community to meet and discuss trends, best practice, and long-term strategies for the prevention and mitigation of complications related to this disease so we can continue to provide the best care for our patients, Dr. Al Janahi said.

Among the speakers at this years event were Dr. Richard Quinton is a Consultant Endocrinologist at the Royal Victoria Infirmary, Newcastle-upon-Tyne, UK; Marius N. Stan, M.D., consultant in endocrinology at Mayo Clinic and Martin Savage is Emeritus Professor of Pediatric Endocrinology at William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary, University of London.

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Over 1500 healthcare professionals attend 7th Qatar Diabetes ... - The Peninsula

Endocrinology

Age- and sex-specific values needed to avoid subclinical thyroid … – Healio

March 14, 2023

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Providers should use age- and sex-specific reference ranges to diagnose subclinical hypothyroidism or hyperthyroidism, especially for older adults, according to a study published in Thyroid.

These data clearly demonstrate the clinical relevance of using age- and sex-specific values, particularly serum thyroid-stimulating hormone levels, when diagnosing subclinical hypothyroidism, Masanobu Yamada, MD, PhD, assistant professor in the department of internal medicine, division of endocrinology and metabolism at Gunma University Graduate School of Medicine in Japan, and colleagues wrote. We found a high rate of overdiagnosed subclinical hypothyroidism, especially in those aged 60 years and older. Although it is a low rate, patients with subclinical hyperthyroidism were underdiagnosed, particularly in middle-aged men and women.

Researchers analyzed health records for 22,992 adults who underwent annual checkups at Takasaki Hidaka Hospital in Japan and 515 euthyroid adults who visited Okamoto Thyroid Clinic in Japan. Of those who visited Takasaki Hidaka Hospital, 14,860 had thyroid function evaluated using a Siemens test kit from 2006 to 2013, and 8,132 had thyroid function evaluated using an Abbott test kit from 2020 to 2022. The Okamoto Thyroid Clinic used kits from Toso to analyze thyroid function from 2016 to 2019.

Subclinical hypothyroidism was defined as elevated serum TSH with normal free thyroxine, and subclinical hyperthyroidism was defined as low serum TSH with normal free T4. The researchers estimated age- and sex-specific reference ranges based on TSH and free T4 measurements and compared them with the manufacturer reference ranges for all three tests.

Using the Siemens test kit, median serum TSH was 1.5 mIU/L for women aged 30 to 39 years and gradually increased with age to 1.9 mIU/L for women aged 60 to 69 years. Men aged 30 to 39 years had a median TSH of 1.4 mIU/L with an increase with age to 1.6 mIU/L for those aged 60 to 69 years. Similar increases were observed for adults tested with the Abbott kit.

Serum free T4 levels were constant with age for women using all three test kits. Men had higher free T4 levels than women and had a gradual decrease with age when using all three kits.

Using the Abbott test kit, median serum free triiodothyronine was 3.26 pg/mL for men aged 30 to 39 years and declined to 3.11 pg/mL for men aged 60 to 69 years. Levels were higher for men compared with women of the same age. Similar findings were observed using the Toso test kit.

About half of women aged 30 to 39 years who were classified as having subclinical hypothyroidism using manufacturer reference ranges had normal thyroid function when age- and sex-specific reference ranges were used. The proportion of overdiagnosed adults increased with age, with 78% of women aged 60 to 69 years classified as having subclinical hypothyroidism being reassessed with normal thyroid function using age- and sex-specific recommendations.

Overdiagnosis was less common for younger men, with no men aged 30 to 39 years and about 5% of those aged 40 to 49 years reclassified with normal thyroid function using age- and sex-specific cutoffs. However, about 62% of men aged 60 to 69 years diagnosed with subclinical hypothyroidism using manufacturer reference ranges were reclassified as having normal thyroid function using age- and sex-specific reference ranges.

The researchers acknowledged several limitations with the study, including a lack of data on adults younger than 30 years or older than 70 years, as well as the potential that reference ranges may be influenced by ethnicity in other countries.

Our findings should therefore be validated in future studies including other racial and ethnic groups, as the prevalence of autoimmune disease may differ according to ethnicity and the geographic location, the researchers wrote.

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Endocrinology

Family’s participation key to advancing diabetes research | VUMC … – VUMC Reporter

When half of their six children were diagnosed with what was then believed to be Type 1 diabetes, David and Ellen Pursell decided their family would participate in research related to the health condition. This family photo from several years ago includes, seated, from left, Peggy, Ramsey and Chrissy. Standing, from left, are Vaughan, Ellen, Martin, David and Parker.

by Jill Clendening

Individuals with Type 1 diabetes have a smaller pancreas than people without diabetes. This is surprising because the pancreatic islets and their insulin-producing beta cells account for just a small fraction of the pancreas, so the loss of beta cells in Type 1 diabetes would not be expected to reduce pancreas size.

Now, a study of one family from Alabama has led Vanderbilt University Medical Center researchers to discover that insulin deficiency, independent of the autoimmunity associated with Type 1 diabetes, is the principal factor leading to a markedly smaller pancreas.

Four members of this family of eight have monogenic diabetes from a rare mutation in the insulin gene, leading to insulin deficiency without autoimmunity. Magnetic resonance imaging (MRI) of the pancreas showed a reduced size and altered shape in the individuals with diabetes. This reduction in size was similar to what had previously been observed in individuals with Type 1 diabetes. These new findings are published in Diabetes Care, a journal of the American Diabetes Association.

While persons with Type 1 diabetes typically have multiple genes that are known to contribute to the development of the autoimmune disorder, individuals with a single mutation that only impacts the insulin gene provided the investigators a unique opportunity to examine the impact of that single factor on pancreas size.

This is a wonderful story about the power of a single family to inform us about the process of a disease that affects millions of people, said Daniel Moore, MD, PhD, associate professor of Pediatrics in the Ian Burr Division of Pediatric Endocrinology and Diabetes. There are not many families, especially not large families, who are known to have exactly this form of diabetes, who could come forward to help us answer this question. But they responded to the call, and theyve provided a really clear answer to a very fundamental biologic question.

About two decades ago, David Pursell and his wife, Ellen, agreed that he and three of their six children who were diagnosed with diabetes would participate in research with the hope more could be learned about the disease. It was as simple as giving a little blood.

They were surprised years later when a researcher from the University of Chicagos Kovler Diabetes Center called to tell them that advances in science had revealed that the four actually had monogenic diabetes due to a mutation in the insulin gene instead of Type 1 diabetes.

Their care remained the same daily monitoring of their blood glucose and multiple doses of insulin each day.

Several more years went by before science came knocking again. Last year, the Pursells were contacted by a team of VUMC researchers who were collaborating with Siri Greeley, MD, PhD, and colleagues at the Kovler Diabetes Centers Monogenic Diabetes Registry at the University of Chicago. The Vanderbilt research team asked if the family could travel to Nashville to have precise measurements of their pancreas taken at the Medical Center.

The VUMC research team, which includes Moore, Jordan Wright, MD, PhD, Jon Williams, PhD, Melissa Hilmes, MD, and Alvin C. Powers, MD, along with colleague Jack Virostko, PhD, at The University of Texas at Austin, had previously found the reduction in pancreas size was present at the time of Type 1 diabetes diagnosis. The Vanderbilt investigators had also organized an international team, the Multicenter Assessment of the Pancreas in Type 1 Diabetes, to develop a standardized MRI imaging protocol to assess pancreas volume and microarchitecture.

We know the pancreas is much smaller in individuals with Type 1 diabetes, but there havent been good models to understand exactly whats going on, said Jordan Wright, MD, PhD, an instructor in the Division of Diabetes, Endocrinology and Metabolism and first author on the manuscript.

One hypothesis is that the autoimmune process of Type 1 diabetes also affects the exocrine part of the pancreas. This is the first time we can actually demonstrate in humans that insulin is a major factor in determining pancreas size and the loss of it leads to a much smaller pancreas.

David and Ellen and their now adult children, Peggy Rice, Vaughan Spanjer, Chrissy Adolf, Ramsey Nuss, and twin sons Parker and Martin Pursell, each had their pancreas size measured using the standardized Vanderbilt MRI protocol. David, Chrissy, Parker and Martin have monogenic diabetes; the rest of the family does not.

When we talked to some of the doctors at Kovler in Chicago, they asked if wed be interested in participating in some trials or research and we said, Of course, anything we can do, said David Pursell. Part of it, Ill admit, was selfish. When we learned our diabetes was not caused by an immune response due to our islet cells being attacked by antibodies, then we thought maybe weve got the chance of getting an islet cell transplant.

But also, were obviously all in this together. If, by virtue of our family volunteering for this research we can help anyone else, we felt like it would be worth it.

The Vanderbilt investigators, as part of MAP-T1D, are building on this study by measuring pancreas size in individuals at known risk of developing diabetes and correlating those measurements with the imminence of a diabetes diagnosis. They also are examining whether reduced pancreas size correlates with other issues such as the need for pancreatic enzymes to support digestion.

This research was performed with assistance from the Vanderbilt University Institute of Imaging Sciences (National Institutes of Health [NIH] project 1S10OD021771-01), the Vanderbilt Institute for Clinical and Translational Research (UL1-TR000445) and the Institute for Translational Medicine (UL1-TR000430) and with the support of the Leona M. and Harry B. Helmsley Charitable Trust, the Juvenile Diabetes Research Foundation, the Doris Duke Charitable Foundation, the NIH (DK104942, DK129979) and the Vanderbilt and Chicago Diabetes Research and Training Centers (DK20593, DK20595).

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Family's participation key to advancing diabetes research | VUMC ... - VUMC Reporter

Endocrinology

Endocrine Society supports EPA rule regulating forever chemicals … – Newswise

Newswise WASHINGTONThe Endocrine Society supports a new U.S. Environmental Protection Agency (EPA) rule which includes provisions to regulate several per- andpolyfluoroalkyl substances (PFAS)including PFOA and PFOSfound in our drinking water.

The proposed regulation sets an aggressive limit for these PFAS and their mixtures and acknowledges effects at extremely low levels by proposing a health based Maximum Contaminant Level Goal (MCGL) of zero. This is the first time the government has regulated a new chemical in drinking water in more than 30 years.

The new rule would require major water treatment upgrades at utilities across the country.

PFAS are manmade chemicals used as oil and water repellents and coatings for common products including cookware, carpets and textiles. PFAS chemicals can contaminate drinking water supplies near facilities where the chemicals are used.

Theseendocrine-disrupting chemicalsdo not break down when they are released into the environment, and they continue to accumulate over time. They pose health dangers at incredibly low levels and have been linked to endocrine disorders such as cancer, thyroid disruption and reproductive difficulties.

While this rule makes important progress towards reducing PFAS in drinking water to improve public health, continued vigilance and a more comprehensive class-based approach will remain necessary as PFAS comprise a large and complex class of chemicals.

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Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the worlds oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site atwww.endocrine.org. Follow us on Twitter at@TheEndoSocietyand@EndoMedia.

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Endocrinology

Lee Health has several big projects in the works in Cape Coral – Naples Daily News

Surfside Medical expansion getting under way in next month or two; service growth at Cape Coral Hospital in the works

Lee Health has numerous projects in the works to address health care needs in fast-growing Cape Coral.

They range from adding physician offices so more specialty services are closer to home for residents, including pediatric care, to expansions at Cape Coral Hospital, according to Dave Kistel, vice president and chief facilities executive.

The board for the publicly-operated hospital system recently approved a contract amendment to expand the Surfside Medical Facility at Veterans Parkway and Surfside Boulevard. The total project cost is $10.4 million and is targeted for completion in January 2024.

The phase-two project involves adding 15,000 square feet of space to the two-story outpatient complex.

Specialists employed by Lee Physician Group in orthopedics, endocrinology, rheumatology, and rehabilitation medicine will go into the new space.

Lee Physician Group currently does not have specialists in orthopedics or endocrinology in Cape Coral so that will become a first in both fields, Kistel said. Rheumatologists have been part time and will become available full time, he said. Outpatient-based rehabilitation medicine has been available at Cape Coral Hospital but is maxed out so the expansion at Surfside will offer a second location.

Overall the expansion of Surfside will mean some patients wont need to commute to Fort Myers for specialty care with Lee Physician Group and wait times to see other specialists will improve, Kistel said.

Cape Coral and its geographic area of 120 square miles has faced steady population growth and is now the eighth largest city in Florida with 204,510 residents, upfrom 154,305 residents in 2010. City leaders in 2021 projected 50-year growth to 430,000 residents.

Forbes Magazine last year ranked Cape Coral as the fourth best place to live in Florida, ahead of Orlando at fifth place and Miami as the sixth best place to live. The first three are Tampa, Jacksonville, and Gainesville.

Forbes pegged median income of Cape residents at around $62,000 and the median home price at $479,000.

Therese Everly, Lee Health board member whose district includes Cape Coral, said the hospital system is committed to expanding services and access to health care throughout the region as Southwest Florida continues to grow.

This is a very exciting time in Cape Coral as we have several new projects underway," she said. "Cape Coral Hospital is the foundation of healthcare in the community, and were proud to be investing in innovative projects in the Cape, such as Bimini Basin, which is community-based."

There's been positive impact bringing internal medicine residency program through Florida State University College of Medicine to Cape Coral, she said.

"Through this residency program and clinic, Lee Health is developing well-educated, highly trained physicians, creating greater accessibility to needed care in the community," Everly said.

The 291-bed Cape hospital is getting some add-ons to keep up with both inpatient and outpatient demand.

Lee Health is planning to lease 47,000 square feet of building space in the future $100 million Bimini Basin project that is in the works by a developer in south Cape Coral.

The Cape Coral City Council approved rezoning and the master concept in February for the mixed-use development with apartments, a waterfront restaurant and shops on three sites south of Cape Coral Parkway.

The plan in the leased space is to offer laboratory services, radiology, womens breast and health care and adult cardiology. The space also will be used for pediatric services in primary care, rehabilitation medicine and behavioral health.

Its a pretty substantial complement of physicians at that site, Kistel said.

When Lee Health will gain access to the leased space depends on the developers time line for construction, he said.

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Lee Health has several big projects in the works in Cape Coral - Naples Daily News

Endocrinology

Hypothalamic inflammation and obesity, study suggests a pathological mechanism – News-Medical.Net

In a recent review published in the European Journal of Endocrinology, researchers discussed current research on the relationship between human obesity and inflammation of the hypothalamus.

Study: Is human obesity an inflammatory disease of the hypothalamus? Image Credit:SciePro/ Shutterstock

In 2022, the World Health Organization (WHO) declared that obesity was a pandemic in Europe, with 60% of the adult population being obese or overweight. Obesity directly reduces longevity and also increases the risk of various other diseases such as cardiovascular diseases, type 2 diabetes, hyperlipidemia, hypertension, gout, and various types of cancers.

Metabolic inflammation and its association with obesity is an area of research that has recently gained attention. Metabolic inflammation involves low-grade chronic inflammation in peripheral tissues such as adipose tissue, the liver, and the hypothalamus. The hypothalamus is thought to be the brain center that regulates appetite and body weight. While hypothalamic inflammation has been studied in animal models and humans, recent research is examining whether hypothalamic inflammation might not be a consequence of obesity but a cause.

The arcuate nucleus in the mediobasal hypothalamus integrates various peripheral endocrine factors and regulates appetite and the feeling of satiety. Two groups of functionally antagonistic neurons are located in the arcuate nucleus. The neuropeptide Y and orexigenic agouti-related peptide neurons form one group, and the anorexigenic proopiomelanocortin and the cocaine and amphetamine-regulated transcript form the other, and all four of these first-order neurons are involved in regulating satiety and appetite. These neurons also express insulin and leptin receptors, which are directly linked to nutrition and energy storage in the body.

Other gastrointestinal tract hormones such as glucagon-like peptide-1, ghrelin, and cholecystokinin can also stimulate the neurons in the arcuate nucleus, mediating appetite and feelings of satiety.

Metabolic inflammation is the moderate but persistent overexpression of pro-inflammatory signals, which has been observed in adipose tissue, the pancreas, the liver, and the hypothalamus. Studies indicate that hypothalamic inflammation is initiated due to different types of metabolic triggers but not body weight. Furthermore, cells such as perivascular macrophages, astrocytes, microglia, and neurons are also involved in the initiation of chronic hypothalamic inflammation. The crosstalk between glia and astrocytes is thought to play a role in the health of the central nervous system (CNS) and various CNS-related diseases.

Some chemokines involved in the feedback between glia and astrocytes have been linked to obesity-associated inflammation. In response to triggers, microglia are thought to secrete pro-inflammatory signals that activate astrocytes. Since astrocytes express leptin and insulin receptors, the sustained activation and feedback between astrocytes and glial cells impact energy homeostasis.

Studies on mice models have found that a hyperlipidemic diet has been linked to impaired insulin signaling and expression of inflammatory response proteins and cytokines in the hypothalamus. Other studies have also associated chronic high-fat diets with increased pro-inflammatory signaling. Saturated fatty acids such as stearic, arachidic, and behenic acids are thought to significantly increase the secretion of pro-inflammatory mediators.

Diets that have a high carbohydrate content have also been linked to the activation of microglia and hypothalamic inflammation. While astrogliosis is linked mainly to lipid metabolism and diets high in sucrose, have resulted in hypothalamic inflammation in mice without astrogliosis, a fructose-rich diet was shown to induce astrogliosis and increase the production of cytokines. Western diets are thought to contain large amounts of saturated fatty acids and monosaccharides commonly, and studies have found links between metabolic inflammation and Western diets and lifestyle. Additionally, factors such as imbalances in the gut microbiome, age-related changes, and neuronal overactivity could be other triggers of hypothalamic inflammation.

High-fat diets are thought to trigger hypothalamic inflammation through various signaling pathways, including toll-like receptor 4, c-Jun N-terminal kinases, protein kinase C, and ceramide pathways, and the induction of endoplasmic reticulum stress.

A method involving T2-relaxation time-weighted magnetic resonance imaging (MRI) had been used to detect hypothalamic inflammation and gliosis in obese individuals. Post-mortem biopsies have also linked gliosis in the hypothalamus to higher body mass index values.

Overall, the findings suggested that hypothalamic inflammation could be a cause and not merely a consequence of obesity. This is supported by the observation that hypothalamic inflammation occurred even before weight gain after the ingestion of high-fat diets. In addition, research on animal models and recent translational human studies have established a link between hypothalamic inflammation and obesity. The development of MRI techniques to detect hypothalamic inflammation could potentially identify targets for pharmaceutical interventions to treat or manage obesity.

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Chinta Sidharthan is a writer based in Bangalore, India. Her academic background is in evolutionary biology and genetics, and she has extensive experience in scientific research, teaching, science writing, and herpetology. Chinta holds a Ph.D. in evolutionary biology from the Indian Institute of Science and is passionate about science education, writing, animals, wildlife, and conservation. For her doctoral research, she explored the origins and diversification of blindsnakes in India, as a part of which she did extensive fieldwork in the jungles of southern India. She has received the Canadian Governor Generals bronze medal and Bangalore University gold medal for academic excellence and published her research in high-impact journals.

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Endocrinology

American Society for Clinical Investigation honors physician … – Washington University School of Medicine in St. Louis

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3 early-career scientists recognized for achievements in research at WashU

Three physician-scientists whose research occurred at Washington University School of Medicine in St. Louis have been honored with the Young Physician-Scientist Award by the American Society for Clinical Investigation. From left, they are Abby Margaret Green, MD; Parker C. Wilson, MD, PhD; and Jing Hughes, MD, PhD.

Three early-career scientists who have conducted their research at Washington University School of Medicine in St. Louis have been honored with the Young Physician-Scientist Award by the American Society for Clinical Investigation (ASCI). They are Abby Margaret Green, MD; Jing Hughes, MD, PhD; and Parker C. Wilson, MD, PhD.

The honor recognizes 50 physician-scientists nationwide who are early in their careers and have had notable achievements in their research. The award supports their involvement with three scientific associations offering leadership development workshops, panel discussions with ASCI members, virtual poster sessions and other career-enhancing activities.

Green, an assistant professor of pediatrics and of pathology & immunology, focuses on the causes of genetic mutations associated with pediatric and adult-onset cancers. She studies how specific enzymes, which cause damage to DNA, promote the development and progression of cancer. The goal of her research is to develop targeted therapies for cancer. In the process, Greens lab emphasizes mentorship. She is affiliated with Siteman Cancer Center and Siteman Kids, and the Roy and Diana Vagelos Division of Biology & Biomedical Sciences.

Hughes, an assistant professor of medicine in the Division of Endocrinology, Metabolism & Lipid Research, studies pancreatic cells that produce hormones that drive glucose metabolism, a key factor in processing and storing energy in the body. Type 1 and Type 2 diabetes can result when glucose levels are too high. Specifically, she analyzes the role in diabetes of an organelle called the primary cilium. Hughes is funded by the National Institutes of Health (NIH) and has established collaborations with other scientists to study the structure and function of pancreatic cells.

Wilson formerly an assistant professor in the Division of Anatomic and Molecular Pathology within the Department of Pathology & Immunology, and the universitys Institute of Clinical and Translational Sciences researches single cell biology and the genetics of kidney disease. Previously, Wilson was a fellow in WashUs Molecular Genetic Pathology program. Earlier this year, he accepted a tenure-track position at the University of Pennsylvania; however, the award recognizes his research conducted at Washington University.

For more information on the awards, please visit ASCI.

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American Society for Clinical Investigation honors physician ... - Washington University School of Medicine in St. Louis