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News Briefs from The Endocrine Society
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Wednesday, December 8, 2010 Contacts: Contact: Arlyn G. Riskind Director, Media Relations Phone: (301) 941-0240 Email: ariskind@endo-society.org Aaron Lohr Manager, Media Relations Phone: (240) 482-1380 Email: alohr@endo-society.org 1. Low and High Vitamin D Levels in Older Women Associated with Increased Likelihood of Frailty 1. Low and High Vitamin D Levels in Older Women Associated with Increased Likelihood of Frailty New study underscores need for large randomized trials to determine efficacy of vitamin D supplementation A recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM) found that lower and higher vitamin D levels were associated with an increased likelihood of frailty in older women. Women with vitamin D levels between 20.0 and 29.9 ng/ml were at the lowest risk of frailty. Vitamin D deficiency and frailty are common with aging. Dimensions of frailty, including weakness and slowness are potential outcomes of vitamin D deficiency and many experts have recommended measuring vitamin D levels in older adults and prescribing vitamin D supplementation if levels are less than 30 ng/ml to prevent adverse health outcomes. This new study however found a U-shaped relationship between vitamin D levels and frailty; older women with vitamin D levels higher than 30 ng/ml and those with levels lower than 20 ng/ml were more likely to be frail. “Vitamin D supplementation has grown in popularity, yet the association between vitamin D status and risk of adverse health outcomes in older adults is uncertain,” said Kristine Ensrud, MD, professor of medicine and epidemiology, Minneapolis VA Medical Center and the University of Minnesota and lead author of the study. “Our study did not find that higher vitamin D status was associated with lower subsequent risks of frailty or death. In fact, higher levels of vitamin D were associated with increased likelihood of frailty.” In this study, researchers measured vitamin D levels and assessed frailty status in a cohort of 6,307 women aged 69 and older. To determine whether lower vitamin D levels were associated with an increased risk of greater frailty status at a later date, 4,551 women classified as non-frail at baseline had frailty status reassessed an average of 4.5 years later. They found that older women with vitamin D levels less than 20 ng/ml and more than 30 ng/ml had higher odds of frailty at baseline. Lower vitamin D levels among non-frail women at baseline were associated with an increased risk of frailty or death at follow-up. “Evidence is lacking to support use of vitamin D supplementation for prevention of frailty and other outcomes including cancer or all-cause mortality,” said Ensrud. “Our results indicate that well-designed large randomized trials of sufficient duration are needed to accurately quantify health effects of vitamin D supplementation, including whether or not supplementation reduces the incidence or progression of frailty in older adults.” Other researchers working on the study include: Susan Ewing of the University of Minnesota in Minneapolis; Lisa Fredman of Boston University in Mass.; Marc Hochberg of the University of Maryland in Baltimore; Jane Cauley of the University of Pittsburgh in Penn.; Teresa Hillier of Kaiser Permanente in Portland, Ore.; Steven Cummings and Peggy Cawthon of California Pacific Medical Center Research Institute in San Francisco, Calif.; and Kristine Yaffe of the University of California in San Francisco. The article, “Circulating 25-hydroxyvitamin D Levels and Frailty Status in Older Women,” appears in the December 2010 issue of JCEM. 2. New Test Shows Promise for Accurate Early Diagnosis of Turner Syndrome A recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM) has demonstrated a novel and accurate test for early diagnosis of Turner syndrome. Turner syndrome affects one in 1,500 to 2,000 female live births and early diagnosis allows for the timely management of short stature and co-morbid conditions including cardiac and renal problems. Turner syndrome (TS) is the most common genetic problem affecting girls with short stature. Average adult height in untreated girls with TS is 4 feet, 8 inches, yet with early diagnosis and initiation of growth hormone therapy, normal or near-normal adult stature can be achieved. Unfortunately, the vast majority of girls with TS go unrecognized until after 10 years of age. This new study suggests a new way to diagnose TS to help prevent delayed recognition. “We have developed a novel approach for diagnosing TS that can be used to practically test large numbers of girls and is much quicker and less expensive than the current methods,” said Scott Rivkees, MD, of Yale University School of Medicine in New Haven, Conn. and lead author of the study. “The new test would also provide the benefit of early detection of other health conditions associated with TS, such as potential renal and cardiac problems.” TS occurs when an X-chromosome is completely or partially deleted. In this study, researchers developed a test based on a quantitative method of genotyping to detect X-chromosome abnormalities. Of 90 clinically-confirmed TS individuals tested, the assay correctly identified 87 (96.7 percent). “Because of the small amount of DNA needed for the test, ample DNA can be extracted from cheek swabs or from newborn screening blood spots that are routinely collected,” said Rivkees. “If broadly used in the clinical setting at young ages, this test can prevent the delayed recognition of TS.” Other researchers working on the study include: Anastasia Wise, Peining Li, Henry Rinder and Jeffrey Gruen of Yale University School of Medicine in New Haven, Conn.; and Karl Hager and Seiyu Hosono of JS Genetics in New Haven, Conn. The article, “A Highly Sensitive, High-Throughput Assay for the Detection of Turner Syndrome,” appears in the March 2011 issue of JCEM. 3. Call for Nominations: The Endocrine Society’s Award for Excellence in Science and Medical Journalism The Endocrine Society is calling for nominations for the fourth annual Award for Excellence in Science and Medical Journalism. The award recognizes outstanding reporting that enhances public understanding of health issues pertaining to the field of endocrinology. The award is open to all credentialed journalists in print (both “hard” and electronic) or broadcast. Candidates can self-nominate or be nominated by someone else. Only one nomination is permitted for each nominee. Submissions can include any work first published between March 1, 2010 and February 28, 2011. Weight will be given to entries that contribute to the public understanding of endocrinology and demonstrate thorough research, accurate reporting and originality. The honor consists of an award to be presented in June at ENDO 2011: The 93rd Annual Meeting & Expo in Boston, Massachusetts. The award recipient will also receive complimentary travel and hotel accommodations to attend the annual meeting. Nomination forms, eligibility and submission requirements can be found at http://www.endo-society.org/media/Journalism-Award.cfm. To apply, please submit the completed nomination form and three copies of the article/work, whether published or taped, to: Aaron Lohr Submissions must be received by March 2, 2011. 4. Hormone Foundation Releases Patient Guide on Post-bariatric Surgery Management As a companion piece to The Endocrine Society’s new clinical practice guideline on post-bariatric surgery management, The Hormone Foundation has published its Patient Guide to Endocrine and Nutritional Management after Bariatric Surgery. The guide briefly describes the different types of bariatric surgery, including those that simply limit the amount of food one can eat and those that limit absorption of nutrients by bypassing portions of the small intestine. The guide also outlines steps patients and their health care team should take to avoid nutritional deficiencies and resulting complications, particularly after malabsorptive operations. It also encourages patients to have realistic expectations about what the surgery can do for them and the lifestyle changes they must make to lose weight and keep it off. The patient guide is online at: http://www.hormone.org/Resources/upload/Post-bariatric-Surgery-WEB.pdf The Society’s clinical practice guideline on post-bariatric surgery is online at: http://www.endo-society.org/guidelines/final/upload/FINAL-Standalone-Post-Bariatric-Surgery-Guideline-Color.pdf 5. JCEM Publishes Summary of IOM Report on Vitamin D and Calcium On November 30, the Institute of Medicine (IOM) set new dietary intake levels for calcium and vitamin D in its report, “Dietary Reference Intakes for Calcium and Vitamin D.” A clinical perspective summary of this report, “What Clinicians Need to Know,” can be found in the electronic version of the Journal of Clinical Endocrinology & Metabolism at: http://jcem.endojournals.org/cgi/rapidpdf/jc.2010-2704v1.pdf. The Endocrine Society’s Clinical Practice Guideline Task Force led by Michael F. Holick, MD, PhD, is nearing completion of its clinical practice guideline on this topic. “Evaluation, Treatment and Prevention of Vitamin D Deficiency” is expected to be published in the spring of 2011. Members of the task force include: Neil C. Binkley, MD, Heike A. Bischoff-Ferrari, MD, DrPH, Catherine M. Gordon, MD, MSc, David A. Hanley, MD, FRCPC, Robert P. Heaney, MD, M. Hassan Murad, MD, and Connie M. Weaver, PhD. More than half of the members of the committee that developed the IOM report are members of The Endocrine Society including: Steven A. Abrams, MD, John F. Aloia, MD, J. Christopher Gallagher, MD, Glenville Jones, PhD, Christopher S. Kovacs, MD, JoAnn E. Manson, MD, Clifford J. Rosen, MD, and Sue A. Shapses, PhD. Following an exhaustive review of nearly 1,000 published studies as well as testimony from scientists and stakeholders, the IOM committee found evidence to support a role for vitamin D and calcium in bone health but not in other health conditions such as protection against cancer, heart disease, autoimmune diseases and diabetes. Overall, the committee concluded that the majority of Americans and Canadians are receiving adequate amounts of both calcium and vitamin D and that emerging evidence suggests that too much of these nutrients may be harmful.
# # # 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. |