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Endocrine Society, June 1-4

The annual meeting of the Endocrine Society (ENDO 2024) was held from June 1 to 4 in Boston, attracting approximately 7,000 participants, including clinicians, academicians, allied health professionals, and others interested in endocrine and metabolic disorders. The conference highlighted recent advances in the diagnosis and management of obesity, endocrine disorders, diabetes, and growth hormone and thyroid diseases.

In one study, Alexander Turchin, M.D., of Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues found that it is important to reduce the weight of individuals with overweight/obesity to decrease their risk for heart attack and stroke, and they noted this should be addressed at the earliest age possible.

Using data from the Nurses' Health Study and Health Professionals Follow-Up Study, the authors evaluated individuals with a body mass index (BMI) greater than 25 kg/m2 at least once during a 10-year period (1990 to 1999) to determine how having overweight/obesity impacted cardiovascular risk (heart attack or stroke) between 2000 and 2020.

The researchers found that individuals who were exposed to excess weight for a prolonged period of time had an increased risk for heart attack and stroke. In addition, prolonged exposure had a greater impact on heart attack and stroke risk than someone's weight at a single point in time. The increase in risk for heart attack and stroke from the prolonged excess weight was only observed in younger individuals (younger than 50 years for women and younger than 65 years for men).

"The key conclusion is that a person's weight at a given point in time is not the final 'sentence' -- one can 'appeal,'" Turchin said. "What matters is what is done about it next. I see this as a glass half-full: even if someone has overweight/obesity at some point in time, they can reduce their risk for heart attack/stroke if they lower their weight over time."

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In another study, Gabriel Castano, M.D., of the Texas Children's Hospital in Houston, and colleagues found that 64 percent of adolescents with obesity and 32 percent of adolescents with type 2 diabetes are denied insurance coverage for glucagon-like peptide 1 (GLP-1) receptor agonists.

The authors evaluated 599 adolescents (average age, 15 years) being prescribed a GLP-1 receptor agonist and found that less than 70 percent of GLP-1 receptor agonists were approved for children with type 2 diabetes and less than 40 percent were approved for weight management. Once a medication was approved, 44 percent of patients treated for obesity did not reach the full treatment dose.

"There is more than just sending a GLP-1 receptor agonist prescription when taking care of children with type 2 diabetes and weight management," Castano said. "There are several limitations that are important to highlight: insurance approval, medication titration, medication engagement, as well as side effects."

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Sriram Machineni, M.D., of the Albert Einstein College of Medicine/Montefiore Medical Center in Bronx, New York, and colleagues found that individuals with no obesity-related medical issues respond to tirzepatide just as well as individuals with two or more medical issues other than type 2 diabetes.

The authors evaluated 4,726 individuals from four different clinical trials. The participants either had obesity or overweight, along with an obesity-related medical condition, and 938 also had comorbid type 2 diabetes. The researchers found that individuals who had two or more obesity-related medical issues were older and had a longer duration of obesity than those with fewer obesity-related complications. In addition, BMI was not higher in patients with more obesity-related medical problems. The presence of more obesity-related medical problems did not affect weight loss from the medication tirzepatide.

"Providers and patients can look forward to a good weight loss response to tirzepatide whether or not they suffer from other medical problems related to their obesity," Manchineni said.

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Mahmoud Nassar, M.D., Ph.D., of the University at Buffalo in Getzville, New York, and colleagues found that GLP-1 receptor agonists are safe to use among individuals with a history of acute pancreatitis.

The authors sought to assess the risk for recurrent acute pancreatitis among individuals with a history of acute pancreatitis treated with GLP-1 receptor agonists. A retrospective cohort study was performed using data from 127 million patients (five cohorts based on type 2 diabetes, obesity, and history of acute pancreatitis, with and without risk factors). The medications assessed included GLP-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors (SGLT2i), dipeptidyl peptidase 4 inhibitors (DPP-4i), and older medications (i.e., metformin and thiazolidinediones).

The researchers found that GLP-1 receptor agonists significantly reduced the risk for recurrent acute pancreatitis compared with SGLT2i, DPP-4i, and not taking GLP-1 receptor agonists, SGLT2i, or DPP-4i. Similar trends were observed in all categories, indicating a consistent reduction in acute pancreatitis risk with GLP-1 receptor agonist treatment.

"GLP-1 receptor agonists are a safe option for treating type 2 diabetes and obesity in patients with a history of acute pancreatitis, but more research is needed to confirm these benefits," Nassar said.

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Alexandra Donovan, Ph.D., of the Charles R. Drew University of Medicine and Science in Los Angeles, and colleagues found early-life stress to be associated with an increased risk for substance use initiation by the age of 13 years.

By separating early-life stress into type (limited resources, family conflict, and traumatic events), the investigators found that family conflict was a predictor of increased risk for substance use in both males and females. Limited resources predicted an increased risk for substance use in females, while traumatic events predicted an increased risk in males, specifically for nicotine use.

"Sex moderates the association between early-life stress and substance use initiation by age 13," Donovan said. "Clinicians working with low-resourced or high-conflict families should advise parents to discuss substance use with their children earlier, and provide alternate positive coping mechanisms."

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ENDO: Novel Male Contraceptive Gel May Achieve Faster Sperm Suppression

WEDNESDAY, June 12, 2024 (HealthDay News) -- A novel male contraceptive gel suppresses sperm production faster than other hormone-based methods for male birth control, according to a phase 2 study presented at the annual meeting of the Endocrine Society, held from June 1 to 4 in Boston.

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ENDO: Teprotumumab Shows Long-Term Efficacy for Thyroid Eye Disease

TUESDAY, June 11, 2024 (HealthDay News) -- Most patients with thyroid eye disease treated with teprotumumab do not require additional treatments nearly two years later, according to a study presented at the annual meeting of the Endocrine Society, held from June 1 to 4 in Boston and simultaneously published online June 2 in Thyroid.

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ENDO: Early Menopause Tied to Heightened Risk for Breast, Ovarian Cancer

TUESDAY, June 11, 2024 (HealthDay News) -- Women with early menopause have a two times greater risk for breast cancer and a nearly four times higher risk for ovarian cancer, according to a study presented at the annual meeting of the Endocrine Society, held from June 1 to 4 in Boston.

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ENDO: Cardiovascular Events Occur Less Often With GLP1-RA, SGLT-2i for T2D, Liver Disease

FRIDAY, June 7, 2024 (HealthDay News) -- For adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease, glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors are associated with reduced risk of cardiovascular events compared with dipeptidyl peptidase 4 inhibitors, according to a study presented at the annual meeting of the Endocrine Society, held from June 1 to 4 in Boston.

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ENDO: Crinecerfont Aids Patients With Congenital Adrenal Hyperplasia

WEDNESDAY, June 5, 2024 (HealthDay News) -- Crinecerfont results in a greater decrease from baseline in the mean daily glucocorticoid dose among patients with congenital adrenal hyperplasia, according to a study published online June 2 in the New England Journal of Medicine to coincide with the annual meeting of the Endocrine Society, held from June 1 to 4 in Boston.

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