Articles in 2008

Use of the second-generation (atypical) antipsychotic agents has led to concerns about possible adverse metabolic effects, including an increased risk of diabetes mellitus. The potential mechanisms underlying treatment-emergent diabetes mellitus, and strategies for effective management of affected individuals, are explored by the author of this Viewpoint.

This article describes a patient with Cushing syndrome presumably attributable to an adrenocortical carcinoma arising from testicular adrenal rest cells. The authors discuss treatment options for adrenocorticotropic hormone-independent hypercortisolism and highlight the difficulties in determining the origin of ectopic cortisol production.

The prevalence of central hypothyroidism is unknown, but might be greater than reported. This disorder may arise from a variety of causes, from tumor-related hormonal disturbances, to mechanical problems related to traumatic brain injury, to being induced by drug therapy. This Review presents an overview of etiologies, diagnosis and management.

Aquaporin subtypes 7 and 9 have vital roles in the control of glycerol channels in adipocytes and hepatocytes, and thereby the balance between glycerol release and uptake by adipocytes and the liver, respectively. This Review discusses the pathophysiological importance of these channels in obesity and related disorders.

Cystic lesions of the pituitary region are quite common but present a challenge for diagnosis and treatment. Several types of cystic lesion are recognized, including cystic pituitary adenomas, Rathke cleft cysts, arachnoid cysts, and craniopharyngiomas. The clinical symptoms and diagnosis of these lesions, and the use of endoscopy for surgical intervention, are discussed in this Viewpoint.

Macrophages have important roles in the complex relationship between obesity, inflammation and insulin resistance that are determined by whether they are classically or alternatively activated by T-helper-1 or T-helper-2 cytokines, respectively. The former leads to insulin resistance and the latter to protection against this condition. This Review discusses this crosstalk between the immune and metabolic systems.

The prevalence of atherogenic forms of apolipoprotein B dyslipoproteinemias is high, but effective treatments are available. Quick, accurate diagnosis is, therefore, essential to providing the best care. In this Review an algorithm is proposed to help distinguish between disease subtypes, based on simple parameters that may be measured by low-cost tests widely available in clinical laboratories.