ENDO 2019 Roundup: Opioids, Obesity, and More

NEW ORLEANS — Some of the latest advancements in the field of endocrinology presented at ENDO 2019 included another promising male birth control pill, real-world data using the artificial pancreas, and the accuracy of HbA1c testing. Below are a few more research highlights from The Endocrine Society’s annual meeting.

Opioids and Hormones

In a review of 15 studies of 3,250 male patients on opioids >6 months, around 65% of them had hypogonadism. In a subset of five studies with 207 male and female patients, 19% had hypocortisolism. The most commonly used opioid in this systematic review was morphine followed by methadone.

“Our study creates awareness of the frequent endocrinological issues in long-term opioid users, and their need for regular endocrine checkups, which are not commonly being done,” said Amir Zamanipoor Najafabadi, an MD/PhD candidate at Leiden University Medical Center in the Netherlands.

He also added in a press statement that “these hormone deficiencies can cause a wide variety of symptoms, such as infertility, extreme fatigue and malaise. People may not recognize these symptoms as possibly related to the increased use of opioids.”

Migraines and Obesity

In a meta-analysis of 10 studies and 473 patients with obesity, losing weight helped to significantly reduce the number of migraine days each month (effect size for headache frequency -0.65, 95% CI -0.88 to -0.42). Claudio Pagano, MD, PhD, of the University of Padova in Italy, and co-authors also showed that a large amount of weight loss, which these patients achieved either through bariatric surgery or behavioral weight loss intervention, helped to significantly reduce pain intensity, disability, and attack duration associated with migraine headaches:

• Pain Intensity: ES -0.81 (95% CI -1.19 to -0.44)
• Disability: ES -0.61 (95% CI -0.77 to -0.45)
• Attack duration: ES -0.35 (95% CI. -0.62 to -0.08)

“If you suffer from migraine headaches and are obese, losing weight will ameliorate the quality of your family and social life as well as your work and school productivity. Your overall quality of life will greatly improve,” Pagano said in a press statement.

“Weight loss reduces the impact of conditions associated with obesity, including diabetes, hypertension, coronary heart disease, stroke and respiratory diseases,” he added.

Dust and Obesity

In a study of nearly 200 household dust samples, 64% showed fat-promoting properties at the cellular level, and 50% caused cells to show signs of proliferation, both at only 100 µg of exposure. Most U.S. children consume around 60-100 mg of dust per day, according to the Environmental Protection Agency.

“We found that two-thirds of dust extracts were able to promote fat cell development and half promote precursor fat cell proliferation at 100 micrograms, or approximately 1,000 times lower levels than what children consume on a daily basis,” said Christopher Kassotis, PhD, of Duke University’s Nicholas School of the Environment in Durham, North Carolina, in a press statement.

“This is some of the first research investigating links between exposure to chemical mixtures present in the indoor environment and metabolic health of children living in those homes,” he added.

Interestingly, among kids under age 4.5 years, more household dust was tied to more triglyceride accumulation, and older kids who lived in houses with more dust tended to have a higher BMI.

PCOS and a Healthy Gut

Cohabitation — allowing for exposure to each other’s gut microbiomes — between a mouse with polycystic ovary syndrome (PCOS) and a healthy mouse resulted in the PCOS mouse having improved symptoms. This included significant improvements in testosterone levels, luteinizing hormone levels, and estrous cycling compared with two mice both with PCOS living together. Additionally, other factors associated with PCOS including weight, fasting blood glucose, fasting insulin levels, and insulin resistance all decreased in mice that lived with a PCOS-free mouse.

“Our new results suggest that altering the gut microbiome via prebiotic or probiotic therapies may be a potential treatment option for PCOS,” said Varykina Thackray, PhD, of the University of California San Diego School of Medicine in La Jolla, California, in a statement.

“Additional research is needed to understand how specific gut bacteria contribute to PCOS and whether the gut microbiome offers potential avenues for treating the condition,” she suggested.