Women’s health (PCOS, menopause, and Turner’s Syndrome)

Several talks zoned in on health issues that affect women – namely PCOS (polycystic ovary syndrome), menopause, and Turner Syndrome. Changes in the gut microbiomes are associated with PCOS; patients have less microbial diversity and limited abundance of specific species. However, a promising study by Dr. Varykina Thackray and colleagues suggests that exposure to a healthy gut microbiome can help relieve the symptoms of PCOS. Thus, the use of specific probiotics/prebiotics might serve as therapeutic tools.

During the meeting, the Endocrine Society unveiled a clinical practice guideline on the pharmacological treatment of osteoporosis in postmenopausal women, which advocates that the benefits of treatment may outweigh the perceived risks. Evidence points to a lack of treatment uptake and adherence, which coincides with a rise in the rate of hip fractures and a drop in bone density screening. It’s hoped that the new guidelines will instill confidence in treatment efficacy and safety. Recommendations include initial treatment with bisphosphonates, in order to reduce fracture risks.

Dr. Patricia Fechner discussed the long-term risks of Turner’s Syndrome (TS); these include short stature, hypertension, heart defects, and premature ovarian failure (hence why diagnosis is so crucial). Regarding the latter, this is common in TS adolescents, and it actually starts in utero. Estrogen replacement therapy can be used to induce puberty and support normal growth and development of the uterus.

Obesity

Asthma has multiple phenotypes, some of which do not fit the ‘classical’ definition – and so classical treatments are ineffective. An example of such a phenotype is obesity-related asthma. The adipose hormone aP2 has been shown to link these two disorders, and a high level of aP2 in obese patients contributes to asthma whilst a low level is protective against it.

A recent study by Dr. Mehmet Furkan Burak and colleagues measured aP2 levels in the blood and lung fluid of individuals with and without asthma, and in normal weight individuals and those who were obese; they found differences in aP2 levels to be most striking in obese asthmatics/non-asthmatics, suggesting that aP2 could be an independent risk factor for obesity-related asthma.

Also, Dr. Christopher Kassotis presented an interesting study on the correlation between fat cell development and chemicals found in household dust. His group collected 194 dust samples from homes in North Carolina; they then extracted the chemicals present in the samples and tested them in a cell model to see if they were capable of initiating fat cell development. They found that a large proportion of the chemicals caused either fat cell development or pre-cursor fat cell proliferation. Given that children consume household dust, this could contribute to obesity.*

Transgender healthcare

This year saw a number of talks focused on the health needs of transgender patients.  Dr. Jacqueline Gutmann covered the various fertility options available to transgender individuals, but also called on healthcare professionals to be sensitive to the fact that certain questions or medical examinations may be uncomfortable and should be approached in a considerate manner, taking time to fully describe all procedures.

Dr. Joshua Safer presented interesting results on the impact of adding a transgender medicine elective to the training program of medical students at Boston University, finding that the elective – which included personal exposure to transgender patients –boosted their comfort and knowledge levels in treating transgender patients.

ENDO 2019 was an excellent meeting, bringing together a range of experts – endocrinologists, geneticists, data analysts and more – for four jam-packed days of ground-breaking research, stimulating discussions, and lively debates. It was also an opportunity for the Endocrine Society to show its support for early career researchers through its Early Career Forum event, and also for women in science by hosting its annual Women in Endocrinology dinner. All in all, a huge success!

* BMC Medicine is now welcoming submissions for an exciting new article collection on childhood malnutrition: ‘Stunting, undernutrition and obesity: the triple threat of childhood malnutrition’. We invite primary research articles and front-matter content investigating the problems and underlying mediating factors of this global health issue, and highlighting the impact of potential solutions.