Abstract:
:Only two drugs are currently approved for long-term use in the treatment of obesity and four others for short-term use. Evaluating the risk-benefit profile is an essential first step. For individuals who have a low body mass index for whom the risk is small, the risk profile must make the drug acceptable for almost everyone. For higher-risk patients, such as those planning intestinal bypass or who have sleep apnea, a wider range of drugs may be considered. Obesity is a chronic disease that has many causes. Treatment is aimed at palliation-that is, producing and maintaining weight loss. Regardless of the primary site of action, the net effect must be a reduction in food intake or increase in energy expenditure.
journal_name
Endocrinol Metab Clin North Amjournal_title
Endocrinology and metabolism clinics of North Americaauthors
Bray GAdoi
10.1016/j.ecl.2008.08.004subject
Has Abstractpub_date
2008-12-01 00:00:00pages
923-42issue
4eissn
0889-8529issn
1558-4410pii
S0889-8529(08)00057-1journal_volume
37pub_type
杂志文章,评审abstract::All organisms must adapt to changing nutrient availability, with nutrient surplus promoting glucose metabolism and nutrient deficit promoting alternative fuels (in mammals, mainly free fatty acids). A major function of glucose-sensing neurons in the hypothalamus is to regulate blood glucose. When these neurons sense g...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2012.11.007
更新日期:2013-03-01 00:00:00
abstract::This article summarizes the clinical features and molecular pathogenesis of medullary thyroid cancer (MTC) and focuses on the current use of molecular, biochemical, and imaging disease markers as a basis for selection of appropriate therapy. Clinicians treating patients who have MTC face the following challenges: (1) ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2007.04.001
更新日期:2007-09-01 00:00:00
abstract::Duplex/color Doppler sonography (US) is the imaging modality of choice for the evaluation of patients with primary amenorrhea. Careful correlation with clinical history, physical examination and laboratory findings significantly narrows the diagnostic possibilities thus allowing for a more precise diagnosis. This arti...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2009.09.002
更新日期:2009-12-01 00:00:00
abstract::Primary aldosteronism used to be considered a rare cause of secondary hypertension. However, accruing evidence indicates that primary aldosteronism is more common than previously recognized. The implications of this increased prevalence are important to public health because autonomous aldosterone production contribut...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2019.08.002
更新日期:2019-12-01 00:00:00
abstract::Osteoporosis is prevalent in transplant recipients and is related to pre- and post-transplantation factors. Low bone density and fractures may antedate transplantation, related to traditional risk factors for osteoporosis, effects of chronic illness, and end-stage organ failure and its therapy, on the skeleton. Bone l...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2007.07.008
更新日期:2007-12-01 00:00:00
abstract::Hypertension is an important and modifiable risk factor for the macrovascular and microvascular complications of diabetes. Prior literature outlines the significance of lowering blood pressure and subsequent cardiovascular and microvascular benefits. Blood pressure targets of less than 140/90 mm Hg are recommended in ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2017.10.008
更新日期:2018-03-01 00:00:00
abstract::Osteoporosis and diabetes mellitus are chronic diseases with significant associated morbidity and mortality. Recent evidence suggests that both type 1 and type 2 diabetes are associated with an increased fracture risk. Fracture as a complication of diabetes must be considered when evaluating and treating patients with...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2013.09.004
更新日期:2014-03-01 00:00:00
abstract::Although biotechnology has provided physicians with essentially unlimited supplies of growth hormone (GH), there are currently only a few clear-cut indications for exogenous GH therapy. Data now support the use of GH in the treatment of children with GH deficiency and short girls with Turner syndrome. Tantalizing prel...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract::This article discusses the evolution of therapy for type I diabetes and considers how physicians should be thinking about the disease in the late 1990s. The biases herein are that management strategy has evolved such that contemporary practice should routinely entail a system of "flexible intensive therapy" directed a...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70272-3
更新日期:1997-09-01 00:00:00
abstract::Thyroid nodules are extremely common, affecting from 4% to 7% of the population. Fine-needle aspiration biopsy is the most accurate and cost-effective technique for nodule diagnosis. It is simple, safe, and should be the first test used in patient work-up. Routine thyroxine (T4) suppressive therapy is no longer recomm...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70282-6
更新日期:1997-12-01 00:00:00
abstract::Glucocorticoid-remediable aldosteronism (GRA) is a hereditary form of primary hyperaldosteronism and the most common monogenic cause of hypertension. A chimeric gene duplication leads to ectopic aldosterone synthase activity in the cortisol-producing zona fasciculata of the adrenal cortex, under the regulation of adre...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章
doi:10.1016/j.ecl.2011.01.012
更新日期:2011-06-01 00:00:00
abstract::Approximately one half of young women who have 46,XX spontaneous premature ovarian failure have ovarian follicles remaining in the ovary. These follicles function intermittently and unpredictably, and pregnancies can occur in these women without intervention, even many years after the diagnosis. Clearly, the term "pre...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(03)00043-4
更新日期:2003-09-01 00:00:00
abstract::This article covers considerations in the etiologies and therapy of hypercalcemia. The differential diagnosis of hypercalcemia is discussed, with particular emphasis on primary hyperparathyroidism and the hypercalcemia of malignancy. Clinical features of hypercalcemia are also discussed. Therapy of hypercalcemia is co...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-06-01 00:00:00
abstract::Glucocorticoid-induced bone loss has been recognized for almost 50 years, yet it remains an important medical problem and a common cause of fracturing. Loss of skeletal mass may occur early in the course of glucocorticoid therapy and appears to be related to the cumulative dose of steroid, as well as to the usual risk...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::Acute hyperkalemia can be a life-threatening consequence of a variety of pathologic, pharmacologic, and iatrogenic disorders. Recognition and prompt therapy often reverse the electrophysiologic complications within minutes. Therefore, physicians must have a thorough understanding of potassium homeostasis. The causes o...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::Ethnicity is a complex yet important construct and an independent risk factor for diabetic heart disease (DHD) with paramount clinical significance. Clinicians should try to better understand the role of ethnicity through more questions. The risk of DHD is modified by ethnicity through more questions. The risk of DHD ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2006.06.004
更新日期:2006-09-01 00:00:00
abstract::The diagnostic term, idiopathic short stature, has emerged over the past 30 years and refers to children with short stature of unknown etiology. Controversy exists regarding the scope of the diagnosis and options for its treatment. This article reviews origins of the diagnosis idiopathic short stature and current diag...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2005.04.003
更新日期:2005-09-01 00:00:00
abstract::The close genotype-phenotype relationship that characterizes thyroid oncology stimulated the authors to address this article by using a mixed, genetic and phenotypic approach. As such, this article addresses the following aspects of intragenic mutations in thyroid cancer: thyroid stimulating hormone receptor and guani...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2008.02.004
更新日期:2008-06-01 00:00:00
abstract::Somatostatin receptor ligands (octreotide and lanreotide) are currently first-line pharmacotherapy for patients with acromegaly in whom surgery fails to control the disease or cannot be considered. The efficacy of a new pan somatostatin receptor ligand, pasireotide, has been investigated as a potential treatment of ac...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2014.10.004
更新日期:2015-03-01 00:00:00
abstract::This article explores many of the ophthalmologic aspects of thyroid-related orbitopathy. The eight main areas of clinical concern--ocular comfort, optic nerve function, exophthalmos, eyelid position, diplopia, cosmesis, soft-tissue signs, and psychologic factors--are discussed so that practitioners may be more secure ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(05)70300-5
更新日期:1998-03-01 00:00:00
abstract::P450c17 commands a central role in human steroidogenesis as the qualitative regulator of steroid hormone flux. Consequently, the study of P450c17 deficiencies in human beings serves to illustrate many aspects of the physiology of steroid biosynthesis and to demonstrate salient features of the genetics and biochemistry...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(08)70021-5
更新日期:2001-03-01 00:00:00
abstract::Adrenal disorders may manifest during pregnancy de novo, or before pregnancy undiagnosed or diagnosed and treated. Adrenal disorders may present as hormonal hypofunction or hyperfunction, or with mass effects or other nonendocrine effects. Pregnancy presents special problems in the evaluation of the hypothalamic-pitui...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章
doi:10.1016/j.ecl.2011.09.001
更新日期:2011-12-01 00:00:00
abstract::Urinary stone disease is the only clinical presentation in patients with cystinuria. Two genes have been associated with type I (SLC3A1) and non-type I (SLC7A9) cystinuria and multiple mutations of these genes have been identified. The type I form is completely recessive while the non-type I form is incompletely reces...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(02)00054-3
更新日期:2002-12-01 00:00:00
abstract::Nonneoplastic and neoplastic proliferative lesions of endocrine cells of the gastrointestinal tract are detailed. A multistep continuum from hyperplasia, dysplasia to neoplasia is identified for histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. Most gastric neuroendocrine tumors (NETs) are s...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2010.08.009
更新日期:2010-12-01 00:00:00
abstract::Cardiovascular disease is a serious complication of diabetes mellitus. In the last 2 decades, great strides have been made in reducing microvascular complications in patients with diabetes through improving glycemic control. Decreasing rates of cardiovascular events have proved to be more difficult than simply intensi...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2013.09.001
更新日期:2014-03-01 00:00:00
abstract::The development of vaccines is arguably the most significant achievement in medicine to date. The practice of innoculation with the fluid from a sore to protect from a disease actually dates back to ancient China; however, with the introduction of Jenner's smallpox vaccine, and greater understanding of the immune syst...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8529(01)00021-4
更新日期:2002-06-01 00:00:00
abstract::In the last 2 decades, diabetes technology has emerged as a branch of diabetes management thanks to the advent of continuous glucose monitoring (CGM) and increased availability of continuous subcutaneous insulin infusion systems, or insulin pumps. These tools have progressed from rudimentary instruments to sophisticat...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2019.10.006
更新日期:2020-03-01 00:00:00
abstract::CVD is the primary cause of morbidity and mortality in patients who have diabetes mellitus. Most such patients have at least one lipid abnormality. Managing these complex lipid disorders is a crucial component of comprehensive diabetes mellitus care and limits the risk for cardiovascular morbidity and mortality. With ...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2004.11.004
更新日期:2005-03-01 00:00:00
abstract::The goal of this article is to differentiate the insulin resistance syndrome from the metabolic syndrome. In the case of the insulin resistance syndrome, the abnormalities and clinical syndromes that are increased in prevalence in insulin-resistant individuals have been summarized, with a brief discussion of the causa...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ecl.2004.03.002
更新日期:2004-06-01 00:00:00
abstract::In summary, patients who will remain on glucocorticoids for more than a few weeks are clearly at risk for osteoporosis. A list of therapeutic strategies is provided in Table 2. While our therapy remains inadequate at this time, newer agents are on the horizon. In the near future, it may be possible to recommend specif...
journal_title:Endocrinology and metabolism clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00