1.   Drinking in Excess Associated with Increased Risk for Metabolic Syndrome
2.   Protein Made by Fat Cells May Increase Risk of Heart Attack in Older Adults
3.   Steroid abuse a serious health risk that demands urgent action: Endocrine Society statement warns
4.   New Hormone Foundation Video Addresses Diabetes Patients' Concerns Associated with Taking Insulin

1. Drinking in Excess Associated with Increased Risk for Metabolic Syndrome

Those who drink in excess of the U.S. Dietary Guidelines (i.e., men who usually drink more than two drinks per day or women who usually drink more than one drink per day) or those who binge drink are at increased risk for the metabolic syndrome, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

The metabolic syndrome consists of a series of risk factors and conditions that are strongly related to cardiovascular disease, the leading cause of death in the United States. These conditions include obesity, high blood pressure, and diabetes.

"These findings are significant because the National Health and Nutrition Examination Survey shows 58 percent of all current drinkers in the United States reported usual alcohol consumption that exceeded the Dietary Guidelines, and 52 percent of all current drinkers reported at least one episode of binge drinking in the past year," said Amy Fan, M.D., Ph.D., of the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), in Atlanta, Ga., and lead author of the study. "Most people who consume alcohol in the United States drink in ways that may increase their risk of the metabolic syndrome and related conditions."

For this study, Dr. Fan and other researchers evaluated data from 1,529 participants of the 1999-2002 National Health and Nutrition Examination Survey. They restricted their analysis to current drinkers (participants who consumed at least 12 alcoholic drinks in 12 months) aged 20 to 84 years. The survey included both an interview and a physical examination that included a blood test. Measures of alcohol consumption included usual quantity consumed, drinking frequency, and frequency of binge drinking.

"Since more than half of current drinkers in our study drank in excess of the Dietary Guidelines limits and reported binge drinking, prevention efforts should focus on reducing alcohol consumption to safer levels," said Dr. Fan. "Unfortunately, few physicians screen their patients about alcohol use or are knowledgeable about guidelines that define low-risk or moderate drinking."

Dr. Fan went on to say that public health messages should emphasize the potential cardiometabolic risk associated with drinking in excess of national guidelines and binge drinking.

Other researchers working on the study include Timothy Naimi, Yan Li, Youlian Liao, Ruth Jiles, and Ali Mokdad of the National Center for Chronic Disease Prevention and Health Promotion, CDC, in Atlanta, Ga., and Marcia Russell of the Pacific Institute for Research and Evaluation in Berkeley, Calif.

The article "Patterns of Alcohol Consumption and the Metabolic Syndrome," will appear in the October issue of JCEM, a publication of The Endocrine Society.

2. Protein Made by Fat Cells May Increase Risk of Heart Attack in Older Adults

Adiponectin, a protein produced by fat cells, may play a pivotal and counterintuitive role in cardiovascular health for older Americans, according to a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM).

As people lose weight, the concentration level of adiponectin in the bloodstream increases. In previous studies, high adiponectin concentration has been associated with lower occurrence of diabetes and cholesterol abnormalities. The new JCEM study reveals, however, that despite the known association with blood sugar and cholesterol parameters, elevated adiponectin levels may lead to heightened risk of heart attack in older adults

This study examined a sample of 1,386 participants of the population-based Cardiovascular Health Study from 1992 to 2001. Participants consisted of adults aged 65 to 100 years and were recruited from four field centers in the United States. Subjects underwent physical examinations and laboratory testing. Of these participants, 604 experienced a heart disease event. Those with the highest levels of adiponectin were most likely to suffer a heart attack.

"This study is significant because previous findings have been contradictory, and the present investigation includes the largest number of heart attacks in an elderly group to date," said Jorge Kizer, M.D., associate professor of medicine and public health at Weill Cornell Medical College and a cardiologist at New York-Presbyterian Hospital/Weill Cornell Medical Center – both in New York, N.Y. "Our findings make a persuasive case that adiponectin is in fact associated with an increase in heart-disease risk in older persons."

Dr. Kizer initially expected that the higher levels of adiponectin would predict lower cardiovascular risk, and studies in middle-aged adults appeared to support this premise. Yet the findings are consistent with recent studies linking higher adiponectin to mortality in the elderly. He said that further studies are needed to understand why adiponectin has such beneficial effects on cholesterol profile and diabetes, but apparently different associations with cardiovascular disease in older adults as compared with middle-aged adults.

Dr. Kizer and others theorize that higher adiponectin concentration may reflect underlying disease processes in the body, or even have direct harmful effects, which may be amplified in the elderly. Adiponectin has been shown to increase energy expenditure through direct actions in the central nervous system in mice, and if this effect were also present in humans, it could be significantly harmful in older adults by accelerating the loss of skeletal muscle, a condition called sarcopenia.

"This study shows that this abundant product of fat cells is a marker and perhaps even a mediator of worsened outcomes in persons aged 65 years and older," said Dr. Kizer. "Further studies should target this protein to unravel the mechanisms responsible."

Other researchers working on the study include Joshua Barzilay of the Emory University School of Medicine in Atlanta, Ga.; Lewis Kuller of the University of Pittsburgh in Pittsburgh, Pa.; and John Gottdiener of the University of Maryland Medical Center in Baltimore, Md.

The article "Adiponectin and Risk of Coronary Heart Disease in Older Men and Women," will appear in the September issue of JCEM, a publication of The Endocrine Society.

3. Steroid abuse a serious health risk that demands urgent action: Endocrine Society statement warns

In light of the upcoming summer Olympics, The Endocrine Society has issued a position statement calling for enhanced detection of steroid abuse among professional and amateur athletes, and greater education to deter teenagers and others from putting their health in jeopardy through steroid doping. The new statement also supports the appropriate clinical use of anabolic steroids.

"The Endocrine Society strongly believes that anabolic steroids and all other hormones should be prescribed and administered only when medically necessary, and only by doctors specializing in the diagnosis and treatment of hormonal disorders," said Society Past-president Margaret Shupnik, PhD. "Safety is our foremost concern, and the public must be aware that there are very serious consequences associated with steroid abuse."

Anabolic steroid abuse has been strongly associated with cardiovascular diseases, including heart attacks and strokes, even in people younger than 30 years of age.

The Endocrine Society also warns that certain so-called "dietary supplements" are actually steroid precursors, which are converted to potent anabolic steroids in the body. These substances include androstenedione, which was banned from over-the-counter sale in the United States in 2004, and dehydroepiandrosterone (DHEA), which is legally sold and widely available.

"A consistent policy and regulatory approach to all hormone precursors, which are in fact drugs, is essential to protect the safety of vulnerable consumers, particularly for substances such as DHEA," said Dr. Shupnik.

In the statement, the Society stresses that there is a definitive line between abuse and appropriate clinical use. Anabolic steroids have clearly appropriate clinical uses, such as treatment of the syndromes of hormone deficiency and HIV/AIDS wasting, but they also have been associated with illicit drugs.

Specific recommendations outlined in this statement include:

″ The U.S. Food and Drug Administration (FDA) should regulate the manufacture and sales of all hormones and hormone precursors, including those currently sold over the counter as "dietary supplements" (e.g., DHEA). This regulation should also include distribution via the Internet.

″ The federal government and professional and amateur sports governing bodies should aggressively publicize the dangers of abusing these drugs and support public outreach programs that specifically target at-risk youths.

″ The federal government should increase funding for research on the development and implementation of high-quality laboratory methodologies for the measurement of hormones, hormone precursors, hormone analogs, and hormone metabolites in samples from humans to detect the abuse of these substances and to diagnose and monitor the treatment of patients with hormonal dysfunction.

 ″ Professional and amateur sports governing bodies should adopt the most consistent, most advanced, and most accurate assays when testing for anabolic steroids and other banned substances.

4. New Hormone Foundation Video Addresses Diabetes Patients' Concerns Associated with Taking Insulin

The Hormone Foundation, the public education affiliate of The Endocrine Society, has produced a new educational video, "Living Your Best Life: Diabetes and Insulin," to address the fears and concerns many patients have about taking insulin.

The documentary-style video follows four patients who illustrate the various methods of insulin administration and how they manage to live full, healthy lives. The video also includes a diabetes educator who addresses glucose testing, insulin storage, and myths about insulin.

The video is available free online for patients and health care providers. Visit www.hormone.org/bestlife to watch the video online.

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Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.