International Journal of Endocrinology and Metabolism
Volume:11 Issue: 3, Jun 2013

Schizophrenia is a debilitating and pervasive mental illness with devastating effects on many aspects of psychological, cognitive and social wellbeing. Epidemiological and life-cycle data point to significant differences in the incidence and course of schizophrenia between men and women, suggesting that estrogen plays a “protective” role. Adjunctive estrogen therapy has been shown to be effective in enhancing the treatment of schizophrenia in women. In men, consideration of estrogen therapy has been impacted by concerns of feminisation, however, clinical trials using estrogen to treat prostate cancer, bone density loss and even aggression in men with dementia or traumatic brain injury, show estrogen to be a safe and effective therapy. Findings do, however, suggest that further exploration of a therapeutic role for adjunctive estradiol treatment in men with schizophrenia is warranted. The development of the new estrogen compounds - Selective Estrogen Receptor Modulators (SERMs) which do not cause feminisation - opens up the possibility of using a different type of estrogen for a longer period of time at higher doses. Estrogen could therefore prove to be an important component in the treatment of psychotic symptoms in men with schizophrenia. This review explains the scientific rationale behind the estrogen hypothesis and how it can be clinically utilised to address concerns unique to the care of men with schizophrenia..

Context: Since 2006 a relevant number of therapeutical algorithms for the management of type 2 diabetes have been proposed, generating a lively debate in the scientific community, particularly on the ideal timing for introduction of insulin therapy and on which drug should be preferred as add-on therapy in patients failing to metformin. At the moment, there is no real consensus. The aim of the present review is to summarize established knowledge and areas for debate with respect to insulin therapy in type 2 diabetes..Evidence Acquisition: In type 2 diabetic patients, insulin represents a therapy with a long and well-established history, but, considering the modern insulin therapy, several points must be carefully examined. The role played by the introduction of insulin analogues, the choice of insulin regimens, the ongoing debate on insulin and cancer, the cardiovascular effects of insulin, the role of insulin on β-cell protection and the actual clinical perspective in the treatment of the disease. Nevertheless, still many exciting expectations exist: the new insulin analogues, the technological options, the inhaled and oral insulin and the issue of transplantation.. Although insulin is the more potent hypoglicemic agent, the availability of a wider spectrum of therapeutic agents, many of which are better tolerated than insulin, has reduced the field of application for insulin treatment; presently, insulin is used only in those who cannot maintain an adequate glycemic control with other drugs. Furthermore, a lively research activity is currently ongoing, in order to make insulin therapy even safer and simpler for patients.

It has been shown that life style modification may decrease the prevalence of metabolic syndrome, but this intervention has not been reported in community setting.. Effect of lifestyle modification on prevalence of metabolic syndrome and its components were assessed in an urban population..In 6870 participants of Tehran Lipid and Glucose Study aged 20-74 years, the prevalence of metabolic syndrome and its components were measured before and after a 3.6 years interval. Lifestyle intervention was employed at a community level including 2961 individuals and also 3909 subjects which were recruited as controls. Logistic regression analysis was adjusted for age, sex and medications.. After 3.6 years, the rise in the prevalence of metabolic syndrome was less prominent in intervention than control group (P < 0.002 for increase of metabolic syndrome prevalence between groups), with an OR of 0.84 (confidence interval 0.75-0.95). After intervention the prevalence of abdominal obesity, elevated fasting glucose levels, elevated triglyceride and low HDL cholesterol were more prominent in control group, as compared to intervention group.. Community based lifestyle modifications in Tehranian adults delayed rise in the prevalence of metabolic syndrome and some of its components..

Fuzzy logic, a mathematical approach, defines the percentage of desirability for recommended amount of food groups and describes the range of intakes, from deficiency to excess.. The purpose of this research was to find the best fuzzy dietary pattern that constraints energy and nutrients by the iterative algorithm.. An index is derived that reflects how closely the diet of an individual meets all the nutrient requirements set by the dietary reference intake. Fuzzy pyramid pattern was applied for the energy levels from 1000 to 4000 Kcal which estimated the range of recommended servings for seven food groups including fruits, vegetables, grains, meats, milk, oils, fat and added sugar.. The optimum (lower attention – upper attention) recommended servings per day for fruits, vegetables, grain, meat, dairy, and oils of the 2000 kcal diet were 4.06 (3.75-4.25), 6.69 (6.25-7.00), 5.69 (5.75-6.25), 4.94 (4.5-5.2), 2.75(2.50-3.00), and 2.56 (2.5-2.75), respectively. The fuzzy pattern met most recommended nutrient intake levels except for potassium and vitamin E, which were estimated at 98% and 69% of the dietary reference intake, respectively.. Using fuzzy logic provides an elegant mathematical solution for finding the optimum point of food groups in dietary pattern..

Although Neuregulin-1 （Nrg1）and its receptors have been indicated at the mRNA level in partial human endocrine organs and its functional roles have been evaluated in vitro, their morphological distribution in higher animals are not fully studied. The present research focused on expression of Nrg1 and its main receptors ErbB2 and ErbB4 in main endocrine organs of the rhesus monkey.. The morphological expression of Nrg1 and its receptors ErbB2 and ErbB4 as well as their potential co-localization were determined by double immunofluorescence in the pituitary, thyroid, parathyroid, pancreas and adrenal gland sample tissues. The expression level of Nrg1 on each sample was indexed by the fold of integrative fluorescence intensity (IFI) relative to that of one cortical tissue.. Differential expression of Nrg1 and their cognate receptors ErbB2 and ErbB4 were found selectively expressed in endocrine organs we tested, with higher expression levels detected in the adrenal gland (AG) and pancreas. Co-localization of Nrg1 with either ErbB2 or ErbB4 was detected in AG, thyroid and parathyroid gland, and Nrg1 was only co-localized with ErbB4 in the islet cells of the pancreas. In the pituitary, adjacent localization of Nrg1 positive cells with ErbB4 positive cells were observed.. This investigation morphologically profiles the differential expression of Nrg1 and its receptors ErbB2 and ErbB4 in the main endocrine organ structures, suggesting an autocrine or paracrine-directed Nrg1-ErbB signaling pathway in some of these structures..

The Malaysian Health and morbidity Survey (2006) reported the highest prevalence of type 2 diabetes mellitus (T2DM) among the Indian population compared to the Malay and Chinese populations. Many studies have supported the important role of adiponectin in insulin-sensitizing, which is associated with T2DM. These studies have raised a research question whether the variation in prevalence is related to the adiponectin concentrations or the lifestyle factors.. The purpose of this study is to determine whether the adiponectin concentrations differ between the Malay, Chinese and the Indian populations with T2DM. It is to investigate the association of adiponectin concentrations with ethnicity, dietary intake and physical activity too.. In this cross-sectional study, a total of 210 T2DM patients with mean (SD) age of 56.73 (10.23) years were recruited from Penang, Malaysia. Data on demographic background, medical history, anthropometry (weight, height, visceral fat, percentage of body fat and waist circumference), dietary intake (3 days 24 hours diet recall) and physical activity (International Physical Activity Questionnaire) were obtained accordingly. Plasma adiponectin and routine laboratory tests (fasting blood sugar, HbA1c, total cholesterol, LDL, HDL and triglyceride) were performed according to standard procedure.. After adjustment for physical activity and dietary intakes, the Indian population had significantly lower adiponectin concentrations (P = 0.003) when compared with the Malay and the Chinese populations, The Indian population also had significantly higher value of HbA1c (P = 0.017) and significantly lower HDL (P = 0.013). Plasma adiponectin concentrations was significantly associated with ethnicity (P = 0.011), dietary carbohydrate (P = 0.003) and physical activity total MET score (P = 0.026), after medical history, age, sex, total cholesterol and visceral fat adjusted. However, dietary carbohydrate and physical activity did not show significantly difference among the various ethnic groups.. In conclusion, lower concentration of adiponectin in the Indian population when compared with the Malay and the Chinese populations is not associated with lifestyle factors. The possibility of adiponectin gene polymorphism should be discussed further..

Maternal nutritional health, before and during pregnancy, influences the health status of herself and her developing fetus. Pregnancy is an important condition for improving nutritional knowledge.. The present study aimed at determining effects of nutrition education on levels of nutritional awareness of a representative group of pregnant women in Western Iran..Patients and A quasi-experimental intervention was undertaken on a random sample of pregnant women (n = 100) attending urban health centers in Ilam city (western Iran) during the year 2011 for prenatal care. A nutritional education program containing two to four lessons was undertaken for small groups of between six to ten women. Nutritional knowledge was assessed before intervention (pretest) and followed by two posttests within three weeks interval.. The awareness level of pregnant women about healthy nutrition was significantly increased from 3% before intervention to 31% after the nutritional education intervention (P < 0.001). This significant difference was independent from maternal characteristics of age and levels of literacy and in obese mothers in particular.. A nutritional education intervention will have a positive effect on nutritional awareness of pregnant women..

The incidence of hypopituitarism in aneurysmal subarachnoid hemorrhage ranges from 0% to 45%. Also the screening for hypopituitarism in survivors of aneurysmal SAH is not a routine. This has led to a controversy in the management of such patients.. The aim of the study was to evaluate the endocrine profile of our patients who had presented with aneurysmal SAH..Patients and This was a prospective study conducted over a period of three years in patients of aneurysmal subarachnoid hemorrhage. The serum samples for levels of free T4, free T3, TSH, prolactin, FSH, LH and testosterone were analyzed at the time of admission and at a follow-up period between 9-12 months. Patients with known endocrine abnormalities, liver or kidney disease and patients with hemodynamic abnormalities were excluded from the study. Abnormalities in levels were noted and a comparative analysis of the hormone levels between the 2-time periods was done. A total of 73 patients were enrolled in the study.. Serum prolactin was raised in 17.80% (13/73) and FSH, LH and testosterone levels were reduced in 12.32% (9/73) of patients in the acute phase at admission. After 9 months follow-up, serum prolactin normalized in all except one patient and in all the males, testosterone level increased significantly. Two patients (3%) developed central hypothyroidism on follow-up.. Chronic hypothyroidism and hypogonadism is not an issue in aneurysmal SAH patients.

Type 2 diabetes mellitus (T2D) is a metabolic disease characterized by dysfunction of pancreatic beta cell and insulin resistance. Liraglutide, which has many special anti-diabetes biological effects, is found to inhibit beta cell death and ameliorate endoplasmic reticulum stress (ERs) induced by free fatty acid (FFA). Macroautophagy (hereafter referred to as autophagy) altered by FFA is also associated with the dysfunction or death of pancreatic beta cells.. We aim at proving that Liraglutide improves the survival of INS-1 cells by promoting autophagy.. Cell survival was assessed by CCK8 assay. The percentage of apoptotic cells was determined by flow cytometric assay after Annexin V-FITC/PI staining. Expression of LC3 was detected by western blotting. MDC staining and transmission electron microscopy (TEM) were used in the measurement of autophagy.. Apoptosis induced by PA in INS-1 cells was significantly resolved after Liraglutide treatment. Simultaneously, autophagy was enhanced with the treatment of PA and Liraglutide. Liraglutide appears to protect INS-1 cells from apoptosis FFA-induced by promoting autophagy.. These findings provide a novel role for GLP-1 analogue in preventing or treating with T2D..

Hashimoto’s thyroiditis is associated with an increased risk of developing papillary carcinoma of thyroid. We hereby report a case of Hashimoto’s thyroiditis with papillary carcinoma in a 45-year-old ear old female diagnosed on fine needle aspiration cytology (FNAC) which was later confirmed on histopathological examination. Such an occurrence, when both lesions are picked up on FNAC in a patient with no palpable thyroid nodule is rare. The case is presented here for its rarity..

Nelson’s syndrome nowadays a rare entity results from an adrenocorticotropin (ACTH)–secreting pituitary adenoma in patients with refractory Cushing''s disease after a therapeutic bilateral adrenal gland removal. We report a case of 25 year old female with cushing’s disease who was initially managed with medical treatment, but in view of severe persistent hyper cortisol state was subjected to bilateral adrenalectomy following which she developed Nelson’s syndrome after a gap of six years, which was difficult to diagnose because of limited investigations available. Patient was managed with stereotactic radiosurgery (gamma knife surgery)..